Restless Legs Syndrome

-
#The Neurology
Question: True & False: Restless Legs Syndrome
  1. Symptoms start with sleep
  2. Dystonia and myoclonus
  3. Symptoms aggravate with dopaminergic agonist
  4. Normal Brain MRI
  5. Sensory symptoms on awakening
(Source: The Neurology: Self-Assessment & Review By Dr. Sunil Kumar, www.theneurology.org)

Reference: Picchietti DL, Stevens HE. Early manifestations of restless legs syndrome in childhood and adolescence. Sleep Med. 2008;9(7):770-781.

 Restless legs syndrome affects approximately 10% of the adult population.

Clinical Features

The four core symptoms required for diagnosis are as follows:
  1. An urge to move the legs: usually caused or accompanied by an unpleasant sensation in the legs
  2. Symptoms begin or worsen with rest
  3. Partial or complete relief by movement
  4. Worsening during the evening or night
Symptoms most commonly begin in the legs, but can spread to or even begin in the upper limbs. The unpleasant sensation is often described as a creepy-crawly feeling, paresthesia, or burning. In about 80% of patients, RLS is associated with periodic leg movements (PLMs) during sleep and occasionally while awake. These involuntary movements are usually brief, lasting no more than a few seconds, and recur every 5–90 seconds. The restlessness and PLMs are a major cause of sleep disturbance in patients, leading to poor-quality sleep and daytime sleepiness. Dopamine agonists relieve symptoms of restless legs syndrome.

 [Answers are: 1. Symptoms start with sleep-True; 2. Dystonia and myoclonus-True; 3. Symptoms aggravate with dopaminergic agonist-False; 4. Normal Brain MRI-True; 5. Sensory symptoms on awakening-False]

Comments

Post a Comment

Popular posts from this blog

Glasgow Coma Scale in Intubated Patients

-
Multiple Choice Questions in Neurology: A 60 year old male patient, known case of Diabetes mellitus and chronic hypertension, presented with sudden onset of right sided hemiparesis and altered mental status. The patient was aspirated and gasping in the emergency room. He was immediately intubated and put on ventilatory support in an intensive care ward. While the patient was on ventilator, doctor examined the patient. He was able to localize painful stimulus from left side of hand. He was able to open eyes on painful stimulus, but unable to open eyes on voice command. What was the Glasgow Coma Scale (GCS) of that patient? 6 8 10 12 Recommendations: Glasgow Coma Scale is very frequently asked topic in neurology entrance examination question paper. This topic should be included in your neurology question bank. Glasgow Coma Scale (GCS) in Tracheostomized or Intubated Patients Glasgow Coma Scale is a neurological scale to assess the level of consciousness of the patient. I
Read more

Blood Supply of Spinal Cord

-
How many spinal arteries supply the human spinal cord? Three Arteries Four Arteries Five Arteries Two Arteries Blood Supply of Spinal Cord Arterial Supply The spinal cord is supplied by Three Longitudinal Arteries : One Anterior Spinal Artery supplies the anterior two-thirds of the spinal cord. Two Posterior Spinal Arteries supply the posterior one-third of the spinal cord. [Mnemonics: Posterior is Paired, Posterior = Paired] Venous Drainage There is a complex network of intrinsic, extrinsic, and extradural systems. The anterior and posterior spinal veins and anterior and posterior radicular veins are freely communicate with the internal vertebral plexus in the epidural space. This drains into the cerebral dural venous sinuses and cerebral veins as well as the external vertebral plexus. The veins of the spinal cord and vertebral column are valveless. Reference: Bosmia AN, Hogan E, Loukas M, Tubbs RS, Cohen‐Gadol AA. Blood supply to the human spinal cord: part
Read more

Neuromuscular Junction

-
High Yield Facts ⭆ Synaptic transmission at the neuromuscular junction begins when an action potential reaches the presynaptic terminal of a motor neuron, which activates voltage dependent calcium channels to allow calcium ions to enter the neuron. Calcium ions bind to synaptic vesicles, triggering vesicle fusion with the cell membrane and subsequent neurotransmitter release from the motor neuron into the synaptic cleft. Motor neurons release acetylcholine (ACh) neurotransmitter, which diffuses across the synaptic cleft and binds to nicotinic acetylcholine ionotropic receptors (nAChRs) on the cell membrane of the muscle fiber. The binding of ACh to the receptor can depolarize the muscle fiber, results in muscle contraction. Normally, Acetylcholine (ACh) binds to α-subunit of Acetylcholine Receptor (AChR) at postsynaptic junction. Which ion is responsible for transmission of impulse from postsynaptic junction to nerve fibers? Chloride (Cl) Calcium (Ca) Sodium (Na) Magnesium (Mg)
Read more