Acute Post-stroke Restless Legs Syndrome:Clinical And The Lesion Location Considerations

Objectives To investigate clinical characteristics and the relationship between the lesion locations and cerebral infarction-related restless legs syndrome(RLS).Methods 376 patients with acute cerebral infarction recruited from Neurology department of Tangshan Gongren hospital between June 2016 and May 2017,were evaluated for RLS.Estabished RLS was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group(IRLSSG)in 2012.Neurological functions were assessed according to the National Institutes of Health Stroke Scale(NIHSS)and modified Rankin Scale(mRS).Severity of RLS was scored based on the International RLS Rating Scale(IRLS-RS).The location infarcts were evaluated with nuclear magnetic resonance imaging(MRI).The associations between risk factors and acute cerebral infarction-related RLS were analyzed by logistic regression.Results 49 patients(13.03%)had RLS.IRLS-RS of cerebral infarction-RLS was 25.24 ± 4.86,were Severity level of RLS.35 patients experienced uncomfortable sensations in the paralyzed lower limb contralateral to the ischemic lesion,14 patients in both lower limbs and paralyzed lower limb were worser,IRLS-RS: 23.05±3.41 vs 30.71 ± 3.42 P<0.001.Patients presented with symptom of RLS(1.89 ± 1.47)day after the onset of infarction.Pramipexole and(or)clonazepam after working time were(1.20 ± 0.46)day,and withdrawal time(9.83 ± 5.05)day.Stepwise logistic regression with NIHSS,temporal lobe,parital lobe,occipital lobe,frontal lobe,callosum,body of caudate nucleus,thalamus,lenticulocapsule,corona radiata,centrum semiovale and pontine as potential predictors revealed that body of caudate nucleus(OR= 16.68,95%CI : 7.99-34.79,P<0.001)temporal lobe(OR =2.63,95%CI : 1.05-6.6,P=0.04)predicted stroke-RLS.A multivariate logistic regression model adjusting for poststroke RLS risk factors,that is gender,age,history of hypertension,history of diabetes,fast glucose,history of coronary heart disease(CHD),history of stroke,smoking,drinking,body mass index(BMI),NIHSS,homocysteine(HCY),Hemoglobin(HGB),platelet(PLT),determined that the prevalence of cerebral infarction-related RLS increased by body of caudate nucleus(OR =91.64,95%CI: 16.44-510.75,P<0.001),temporal lobe(OR=6.48,95%CI :1.4-30.03,P=0.017),pontine(OR=7.09,95%CI: 1.4-35.99,P=0.018),hostory of CHD(OR=3.81,95%CI: 1.17-12.47,P=0.027).NIHSS(OR=1.13,95%CI: 0.91-1.41,P=0.278)and mRS(OR=1.68,95%CI : 0.78-3.62,P=0.188)were no associated with cerebral infarction-related RLS.Conclusions cerebral infarction-related RLS usually occurs in the paralyzed limbs contralateral to the infarction lesion,whereas bilateral symptoms were exhibited by more severity level of RLS.Symptom of RLS were severe.The lesions located in temporal lobe,body of caudate nucleus are associated with cerebral infarction-related RLS.