不宁腿综合征(复旦大学华山医院+王坚)PPT.ppt

Sometimes the patient’s bed partner reports having seen frequent leg or limb movements during sleep years before the patient recognized sensory symptoms. Not all patients with RLS have periodic limb move ments of sleep, and not all patients with such movements have RLS, making the identification of these movements of questionable value in diagnosis. 一直进展。除非药物干预。 RLS is generally a chronic condition [21–23,25]. This is true not only of patients, but of affected family members who have not yet come to medical attention for the condition [41]. Over 95% of family members of RLS patients who have experienced RLS symptoms continue to have them through time of interview. While patients generally report a progressive course, family members may not. Instead, they may report stable manifestations or even a decrease in symptoms. 影响睡眠。Whether because of the sensory symptoms or associated periodic limb movements of sleep, RLS may have profound negative effects on sleep. Symptoms of insomnia or fatigue may be the problem that is initially reported; in addition, reduced concentration and memory, decreased motivation and drive, and depression and anxiety may be reported. While one theory of RLS suggests that this condition is similar to Parkinson’s disease (PD) in having an underlying dopamine abnormality [44], the sensory [45] and motor [46] findings characteristic of PD are not found in RLS. However, if RLS is due to another condition, such as a peripheral neuropathy [47], uremia [48], or anemia [49], findings typical of those disorders may be present in the RLS patient. Clinical experience, which is gained primarily from more-severe cases of RLS, has previously contributed to the conclusion that RLS is generally a chronic condition. This may be the case, but for patients with milder RLS, the pattern of expression of the disorder appears to be variable with long periods of remission and sometimes with expression only for a limited time of life. Certainly the natural co