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Master Thesis

Le syndrome des jambes sans repos, diagnostic différentiel de la spasticité dans la population des blessés médullaires

Abstract : Introduction: The Restless syndrome (RLS) is a sensorimotor disorder characterized by an urgent need to move the limbs (typically the legs), associated with unpleasant feelings, painful during late afternoon or early night. Periodic leg movements (PLM) may be attached during sleep, characterized by a extension movement of the hallux, dorsiflexion of the ankle and sometimes knee flexion and hip. The pathophysiology of RLS is not fully understood.In the literature, studies have shown an increased prevalence of RLS in patients with Spinal cord Injury (SCI) or Multiple Sclerosis (MS). Objective: the diagnosis of spasticity or RLS in patients complaining of repeated nocturnal spasms initially addressed in consultation because of spasticity resisting to pharmacological treatment. Method: Prospective study, from March 2014 to June 2015, monocentric, in the MPR Service Hospital Raymond Poincaré. Inclusion criteria: age over 18 years, SCI, MS patients, with nocturnal predominance spasms. Exclusion criteria: presence of pressure sores, unable to achieve a polysomnogram. Weekday hospital patients for predominantly nocturnal spasms resistant to pharmacological treatment of spasticity orally or even to intrathecal therapy (IT) IT baclofen, associated with sleep disorders, enjoyed a polysomnography. If RLS exists, 0.18 mg of pramipexole was administered to the patient, followed by a control polysomnography. Results: 18 patients: 7 (MP), 11 (SCI) were included. All had polysomnography for a RLS. All of them had, during the medical examination, 4 main criterias of RLS & 16 of the PLM of the polysomnography record. A significant improvement was experienced on 10 patients, with a important reduction (PLM) on polysomnography control, after administration of pramipexole. Conclusion: This pilot study shows that RLS may be a differential diagnosis of spasticity. The presence of spasms with predominance nocturnal or during supine position, in patients with type of central nervous system lesions (SCI) or (MS) has to search for RLS and test the effect of dopamine agonists in case of positive diagnosis.
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Master Thesis
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Submitted on : Tuesday, April 19, 2016 - 2:24:54 PM
Last modification on : Friday, March 27, 2020 - 2:18:38 AM
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  • HAL Id : dumas-01304255, version 1


Elsa Mauruc Soubirac. Le syndrome des jambes sans repos, diagnostic différentiel de la spasticité dans la population des blessés médullaires. Médecine humaine et pathologie. 2015. ⟨dumas-01304255⟩



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