Coletti Moja Mario, Cravero Erika, Logozzo Irene, Mairano Claudia, Labate Carmelo
Department of Neurology, Mauriziano Hospital Umberto I, Torino, Italy.
Department of Rehabilitation, Mauriziano Hospital Umberto I, Torino, Italy.
Case Rep Neurol. 2022 Mar 21;14(1):162-166. doi: 10.1159/000522334. eCollection 2022 Jan-Apr.
Periodic limb movements (PLM) and restless leg syndrome (RLS) are involuntary common sleep-related movements which often hamper sleep onset; they are mostly idiopathic and bilateral but are seldom described secondary after a stroke. These cases are rare, often unilateral, and because of the usually transitory duration of symptoms, often under-recognized. When a treatment is required, it can be tricky and the drug choice not foregone. We report 2 patients with unilateral poststroke PLM with similar clinical pictures but different symptoms, therapy, and outcome. The first is a long-lasting unilateral PLM video case with chronic vascular lesions leading to insomnia even if with no urgence or any subjective symptoms as in RLS but well responding only to a definite RLS treatment. The second case is an acute, short-duration self-limiting PLM with positive brain MRI lesion imaging. Our cases suggest that unilateral poststroke PLM even if distinct in subjective and radiological features from secondary RLS can sometimes have a definite and effective dopaminergic treatment if long-lasting. Putative mechanism of chronic case 1 PLM could be due to a further stroke sparing sensory pathways and making the patient unaware of subjective RLS-like symptoms.
周期性肢体运动（PLM）和不宁腿综合征（RLS）是常见的与睡眠相关的不自主运动，常妨碍入睡；它们大多为特发性且双侧发病，但很少在中风后作为继发性情况被描述。这些病例很罕见，通常为单侧发病，且由于症状持续时间通常较短，常常未被充分认识。当需要治疗时，治疗可能很棘手，药物选择也并非确定无疑。我们报告了2例中风后单侧PLM患者，他们有相似的临床表现，但症状、治疗方法和结果不同。第一例是一个长期的单侧PLM视频病例，伴有慢性血管病变，导致失眠，即使没有像RLS那样的紧急情况或任何主观症状，但仅对明确的RLS治疗有良好反应。第二例是急性、短期自限性PLM，脑部MRI病变成像呈阳性。我们的病例表明，中风后单侧PLM即使在主观和影像学特征上与继发性RLS不同，但如果是长期的，有时也可能有明确且有效的多巴胺能治疗。病例1慢性PLM的推测机制可能是由于再次中风，感觉通路未受影响，使患者未意识到类似RLS的主观症状。
