RESTLESS LEGS SYNDROME AND INSOMNIA FREQUENCY IN PATIENTS WITH PSORIASIS.

BACKGROUND: To assess the prevalence and severity of RLS in psoriasis patients and to investigate its effects on sleep and quality of life. METHODS: Seventy patients with psoriasis in Trakya University Medical Faculty Dermatology Department and also applied to Neurology Department in the same center and 70 volunteer controls were enrolled in the study. Severity of the Restless Legs Syndrome (RLS) was determined using International Restless Legs Syndrome Study Group (IRLSSG) criteria among the patients who have been diagnosed with RLS based on IRLSSG criteria. The presence of insomnia in patients was detected using International Classification of Sleep Disorders (ICSD-II) criteria. Additionally, to evaluate the severity of the disease and quality of life, Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) tests were applied to the patients with psoriasis. RESULTS: RLS frequency in patients with psoriasis was 28 (40%) compared to the control group 10 (14.2%), and the difference was statistically significant (p<0.001). IRLSSG severity scores were higher in patients with psoriasis who had insomnia secondary to RLS compared to those who did not have insomnia (p<0.001). The mean values of PASI were 7.54 +/- 6.52 in the presence of insomnia and 3.27 +/- 2.69 in the absence of insomnia. The difference was statistically significant (p<0.001). No significant difference was found in DLQI scores between patients with RLS and without RLS or between patients with and without insomnia (p>0.05). DISCUSSIONS: RLS frequency in patients with psoriasis was significantly higher than in the control group. In addition, we found that RLS is more common but RLS severity was mildly high in patients with psoriasis relative to controls. However, there was a correlation between the increase in severity of RLS with secondary insomnia patients who were diagnosed with RLS. It may be beneficial to consider RLS and insomnia for each patient diagnosed with psoriasis.

[A case of painful legs and moving toes syndrome treated with gabapentin]. / Gabapentin tedavisine belirgin yanit alinan agrili ayaklar ve hareketli parmaklar sendromu.

A 58-year-old woman was evaluated following complaints of pain in both lower extremities and brief involuntary movements in her toes, which had begun 2 years prior. No signs were present beyond a curling, flexion/extension, abduction/adduction movement in the toes of both lower extremities, voluntarily stoppable during neurologic examination. During investigation into etiology, lumbar vertebrae MRI revealed a posterior annular protrusion causing partial compression of the dural sac and neural elements by the L3-4 and L4-5 discs. Semirhythmic repetitious movements were detected on electromyography performed on right extensor digitorum brevis (EDB) muscle with 200 mV and 1 Hz frequency. Patient was put on a gradually increased dose of gabapentin, starting at 1200 mg/day. A brief regression in pain and involuntary movements in feet and toes was observed. GABAergic agents are very effective treatment of painful legs and moving toes syndrome. The present clinically and electrophysiologically diagnosed case was considered worth reporting, as painful legs and moving toes syndrome is a very rare condition.

R-R interval variation and sympathetic skin response in systemic lupus erythematosus.

The involvement of the autonomic nervous system is less common than that of the central and peripheral nervous system in systemic lupus erythematosus (SLE) patients. However, its involvement can negatively affect the quality of life of the patient and cause life-threatening situations. In this study, autonomic function was evaluated in SLE patients who did not show any sign of autonomic involvement using R-R interval variation (RRIV) and sympathetic skin response (SSR) electrophysiological tests. SSR was used to evaluate the sympathetic nervous system, whereas RRIV was used for the parasympathetic nervous system. We included 23 SLE patients and 21 healthy volunteers in the study. Of the 23 SLE patients, 20 (86.9 %) were female and 3 (13.1 %) were male. The age range of the patients was between 19 and 52 years, with a mean age of 32.5 ± 9.1 years. Routine nerve conduction studies and autonomic tests were performed on patients in the electromyography (EMG) laboratory. Lower extremity SSR latencies were prolonged and a significant loss of amplitude was observed in comparison to the control group. Furthermore, deep-breath RRIV values for the patient group were significantly lower than that of the control group. Both sympathetic and parasympathetic nervous system involvement was seen in our study. In conclusion, EMG can reveal a possible underlying involvement in the absence of signs of autonomic involvement.