RESUMEN
OBJECTIVE: Restless legs syndrome is characterised by discomfort during rest and an urge to move the limbs that is accompanied by abnormal sensations. Studies on disease pathophysiology have focused on dopaminergic dysfunction. Vitamin D may play an important role in dopamine function, but the role of vitamin D in restless legs syndrome has not been examined. We compared the serum vitamin D levels of RLS patients and matched controls and explored the correlation of plasma vitamin D levels with disease severity. PATIENTS/METHODS: We measured serum 25-hydroxyvitamin D levels in 36 patients with restless legs syndrome and compared them to 38 healthy control subjects. RESULTS: The mean serum 25-hydroxyvitamin D levels were 7.31±4.63 ng/mL in female patients with restless legs syndrome and 12.31±5.27 ng/mL in female control subjects (p=0.001). We found a significant inverse correlation between vitamin D levels and disease severity in females (p=0.01, r=-0.47). CONCLUSION: The mean serum vitamin D levels were lower in female patients with restless legs syndrome. Low vitamin D levels may cause dopaminergic dysfunction in restless legs syndrome patients. Further studies are required to confirm these results.
Asunto(s)
Síndrome de las Piernas Inquietas/sangre , Vitamina D/análogos & derivados , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Síndrome de las Piernas Inquietas/fisiopatología , Factores Sexuales , Vitamina D/sangreRESUMEN
We report a case with recurrent, transient attacks of slurred speech, weakness, and numbness of the right half of the face and the right arm without seizure activity, accompanied by headache and double vision. Neurologic examination revealed bilateral papilledema and right abducens palsy. Brain magnetic resonance imaging revealed thrombosis of the dural venous sinuses and the cortical veins, with no evidence of parenchymal lesion. Homozygous mutations were found for methylenetetrahydrofolate reductase (MTHFR) A1298C and MTHFR CG677T. Anticoagulation with heparin and warfarin resulted in prompt cessation of the transient attacks, as well as the signs and symptoms of increased intracranial pressure. This report documents that, although rare, transient ischemic attacks can result from cerebral venous thrombosis.
Asunto(s)
Ataque Isquémico Transitorio/enzimología , Ataque Isquémico Transitorio/genética , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Mutación Puntual/genética , Trombosis de los Senos Intracraneales/enzimología , Trombosis de los Senos Intracraneales/genética , Venas Cerebrales/diagnóstico por imagen , Venas Cerebrales/patología , Venas Cerebrales/fisiopatología , Diagnóstico Diferencial , Homocigoto , Humanos , Ataque Isquémico Transitorio/diagnóstico , Masculino , Metilenotetrahidrofolato Reductasa (NADPH2)/deficiencia , Radiografía , Trombosis de los Senos Intracraneales/diagnóstico , Adulto JovenRESUMEN
Cerebral venous thrombosis rarely develops after lumbar puncture and spinal anesthesia with accidental dural puncture, however, occurrence of isolated cortical vein thrombosis after epidural anesthesia is extremely rare. We report three cases who developed postural headache and isolated cortical vein thrombosis after epidural anesthesia. We postulate that intracranial hypotension is the cause of compensatory venous dilatation and resultant thrombosis.
