Incidence, Phenotype and Course of Acute Onset Restless Legs Syndrome (+ 4 Weeks) In Patients With Acute Stroke – Prospective Observational Cohort Study

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Makwana, Aditii N.
Restless Legs Syndrome , Willis-Ekbom Disease , Obstructive Sleep Apnea , Stroke-Related RLS , Subcortical Stroke , Cerebral Small Vessel Disease
Objectives: The objective of this study was to determine prevalence of acute (new) onset restless legs syndrome (RLS) and of chronic bilateral symmetrical RLS in patients with recent stroke and evaluate the relationship with cardiocerebrovascular parameters like history of hypertension, subcortical location of stroke and cerebral small vessel disease. Methods: Consecutive acute stroke patients were recruited from the stroke unit of the Kingston Health Sciences Centre; total of 113 patients were included in the study. A pre-determined sleep questionnaire was administered, and details of stroke and hematology were collected from the hospital database for analysis. RLS diagnosis was done according to the criteria determined by the International Restless Legs Syndrome Study Group (IRLSSG). Results: Out of 113 patients, 30 patients (26%) met the IRLSSG criteria and were diagnosed with RLS, the majority of them being women. RLS diagnosis showed a statistically significant association with subcortical stroke location and cerebral small vessel disease. Half of these patients showed similar or worsening RLS symptoms upon a three to six month follow up. Conclusion: RLS prevalence in the stroke population has consistently been shown to be associated with subcortical stroke regions, highlighting its capability as a predictive factor for stroke and vice versa. Patients that develop acute RLS or other sleep disorders can experience symptoms for months post-stroke; therefore, detailed diagnostic and therapeutic interventions would be helpful in stroke recovery.
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