Single-question screen for restless legs syndrome  

Oleh:

Moller, J Carsten ; Oertel, Wolfgang H

Jenis: Article from Bulletin/Magazine - ilmiah internasional
Dalam koleksi: Medical Progress vol. 35 no. 07 (Jul. 2008), page 317.

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Perpustakaan FK Nomor Panggil: M36.K.2008.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Background: Restless legs syndrome (RLS) is currently diagnosed using four essential criteria. the international RLS Study Group rencently proposed a method to rapidly screen for RLS in neurological practice by asking the patient a single question. "When you try to relax in the evening or sleep at night, do you ever have unpleasant, restless feelings in your legs that can be relieved by walking or movement?" Objective: To validate the use of a single standard question for the rapid screening of RLS, and to analyze the effects of the presence of RLS on global clinical severity, cognitive function, and self-assessed daytime sleepiness. Design and Intervention: the investigators recruited 521 consecutive patients (252 female, 269 male; mean age 60.7 years, range21-88 years) who prensented to a neurology cilnic in Italy. No particular inclusion criteria were used, but patients were excluded if they had dementia or other types of disease that affected their ability to understand the applied tests and questions. The study also had a control group of 45 individuals (29 female, 16 male; mean age 68.2 years, range 40-95 years) who had no neurological abnormalities or other major disease (mild untreated blood hypertension or arthritis were permitted); by definition, this group did not include any patients with a diagnosis of RLS. Patients and controls were assessed with the four essential diagnostic criteria for RLS, the Epworth Sleepiness Scale (ESS), the Clinical Global Impression of Severity (CGI-S), and the Mini-Mental State Examination (MMSE). The treating clinician posed the sigle screenig question, translated into Italian. A sustected diagnosis of RLS was independently confirmed by two senior Clinicians. Outcome Measures: The main Outcome parameters were the sensitivity and specificity of the screening question for identifying patients with RLS. Result : A total of 112 (21.5%) patients met the four criteria for RLS; their mean age was 61 years (range 26-88 years) and 64 were female. The most common subdiagnosis was idiopathic RLS (n= 70). Al the patients who had been diagnosed with RLS, and 13 patient without a formal diagnosis of RLS, responded in the affirmative to the single screening question. None of the patients who answered 'no' t o the single question was diagnosed with RLS. Two healthy controls also reponded 'yes' to the single question. These findings translated into a sensitivity of 100% and a specificity of 96.8% for the single question to diagnose RLS. Patients with RLS reported more daytime sleepiness (significantly higher ESS scores) than did healthy control; the highest ESS scores were found in those with secondary RLS. CGI-S scores were also significantly higher in RLS patients than in controls. The MMSE did not differ between the two groups. Conclusions: The single question is well suited to the initial screening of patients with neurological disease for the presence of RLS. A formal diagnosis of RLS was associated with increased sleepiness during the day.

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