Abstract Details

Title Restless Legs Syndrome (RLS) May Be Overdiagnosed and Pharmaceutical Agents May Be Misused

Topic Sleep

Presentation(s) P05 - (-)

Poster/Presentation
Number 023

Objective

Background BACKGROUND: The IRLSQ is routinely administered to all patients presenting to our sleep disorders center. We and others have noted on polysomnography (PSG) that movements frequently occur with arousals during epochs formally scored as wake. These arousals delay sleep initiation. We wondered whether these movements would lead patients to answer affirmative to all four questions of the IRLSQ, and thus lead to an erroneous diagnosis of RLS.

Design/Methods DESIGN/METHODS: We administered the IRLSQ to all patients undergoing PSG from November 1, 2010 to November 1, 2011. Patients answering affirmative to all four questions were given a diagnosis of Restless Leg Syndrome (RLS, 333.94). Others with sleep-related waking movements were given a diagnosis of Sleep Related Movement Disorder (SRMD, 327.59).

Results RESULTS: The IRLSQ responses from 659 patients and their respective diagnostic PSG's were evaluated. 296 of these patients (44.9%) had SRMD only; 69 (10.5%) had RLS only; 68 (10.3%) had both SRMD and RLS; and 226 (34.3%) had neither. 70 (13.4%) had been prescribed RLS pharmacotherapies prior to evaluation at our sleep center, even though they did not meet formal RLS criteria. Additionally, 25 (18.2%) had Lumbar Radiculopathy (LR), and 120 (87.6%) had SDB only.

Conclusions CONCLUSIONS: 1. Patients can confuse RLS-like movements caused by other sleep disorders with the questions asked on the IRLSQ. 2. This confusion can lead to inappropriate pharmacotherapy in patients who have other sleep disorders. 3. In this series, RLS-like movements continue to be associated with lumbar radiculopathy.

Authors/Disclosures
Vernon D. Rowe, MD, FAAN PRESENTER	No disclosure on file
John A. Hunter	No disclosure on file
	No disclosure on file
Kenneth R. VanOwen, MD (Houston Neurological Inst)	No disclosure on file
	No disclosure on file
Richard J. Barohn, MD, FAAN (University of Missouri)	Dr. Barohn has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for NuFactor. The institution of Dr. Barohn has received research support from FDA OPD R01. Dr. Barohn has received intellectual property interests from a discovery or technology relating to health care.

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