Validation of an Arabic version of the Cambridge-Hopkins diagnostic questionnaire for restless legs syndrome.

PURPOSE: To validate an Arabic version of the short form of the Cambridge-Hopkins diagnostic questionnaire for restless legs syndrome (CH-RLSq13). METHODS: The Arabic version was created using a standard forward-backward translation method. A pre-final Arabic version was administered with the original English version to a group of bilingual subjects as a pretest. The inter-rater agreement between these two versions was measured. A finalized Arabic version was obtained. For the validation, the Arabic version of the CH-RLSq13 was administered to Lebanese subjects, above 18 years old, selected upon a clinical interview. The diagnosis provided by the Arabic version of the CH-RLSq13 was compared to the clinical diagnosis made by a neurologist at Hotel-Dieu de France hospital. Inter-rater agreement was assessed using Cohen's kappa coefficient. Sensitivity, specificity, and positive and negative predictive values of the translated questionnaire were calculated. RESULTS: Inter-rater agreement, between the 2 versions, for the entire questionnaire, was excellent (κ = 0.950). All items showed a substantial level of agreement between the two versions. In the validation process, 91 participants were included (17 patients diagnosed with RLS and 74 control subjects). The mean age was 40 years, with female predominance. The final Arabic version of the CH-RLSq13 had a sensitivity of 71%, a specificity of 100%, and with negative and positive predictive values of 94% and 100% respectively. CONCLUSION: The Arabic version of the CH-RLSq13 is a reliable tool for the screening and diagnosis of RLS in Lebanese and Arabic-speaking populations.

Topography of the sensations in primary restless legs syndrome.

OBJECTIVES: To evaluate the topography of restless legs syndrome (RLS) sensations and to compare subgroups of patients based on RLS topography. METHODS: Forty-four treated patients with primary RLS were interviewed and reported the localization of RLS sensations on body diagrams. RESULTS: RLS sensations were felt deep inside the muscles of mainly the middle portions of the lower limbs in 86% of patients. Superposition of patients' drawings showed a predominant involvement of the upper calves (75%). RLS sensations were diffuse, affecting on average 21% of the body. They occurred bilaterally, but also unilaterally (41%). During symptomatic periods, 66% of the patients experienced sensations spreading, frequently from the legs to other limbs segments. Clinical features were similar in patients with sensations: superficial versus strictly deep; limited or not to the lower limbs; unilateral versus strictly bilateral; and spreading or not. The percentage of affected surface did not correlate with patient age, age at RLS onset, RLS duration and severity. The percentage of affected area in the lower limbs correlated with the one in the upper limbs (r=0.53; p=0.0003). CONCLUSION: RLS sensations affect large body areas (predominantly the upper calves). Body diagrams could be used to explore the evolution of RLS topography and treatment effects.

Sensations in restless legs syndrome.

OBJECTIVE: To characterize the verbal descriptors of the sensations in restless legs syndrome (RLS) in depth. METHODS: Fifty-six patients with primary RLS (interviewed in person) and 738 members of the French RLS Association (sent a postal questionnaire) were included in the study. Patients in the clinical series were asked to report their RLS sensations in detail. The two groups completed a French reconstruction of the McGill Pain Questionnaire (QDSA) to assess their RLS sensations. RESULTS: All patients in both groups had abnormal sensations associated with the urge to move the legs. Most patients in the clinical series reported spontaneous "electrical," "prickling," "burning," "tingling," and "itching" sensations. In the QDSA, more than two-thirds of subjects in both groups selected the sensory subclasses "temporal" and "paresthesias," and the affective subclasses "evaluative," "nervous tension," "asthenia, fatigue," and "punishment." More than one-third of subjects chose the sensory words "electric shocks," "irradiating," and "tingling," and the affective words "exhausting," "distressing," "unbearable," "irritating," and "depressing." The subjects used more heat than cold descriptors to express their sensations. CONCLUSION: RLS is a primary sensory disorder without any pure motor form. The sensory descriptors in RLS could be similar to those of neuropathic pain, except for rare cold and numbness sensations.