- Email: [email protected]
15. Levodopa for idiopathic restless legs syndrome: Systematic review
Society Proceedings / Clinical Neurophysiology 120 (2009) e1–e7
15. Levodopa for idiopathic restless legs syndrome: Systematic review—C.F. Conti, M.M. Oliveira, J.S. Valbuza, R.B. Andriolo, N.A. Atallah, L.B.C. Carvalho, L.B.F. Prado, G.F. Prado (Neuro-Sono, Department of Neurology and Department of Emergency and Evidence, Federal University of São Paulo – UNIFESP, São Paulo, Brazil) Background: Restless Legs Syndrome (RLS) is a sensory motor disorder characterized by a distressing urge to move the legs and sometimes also other parts of the body usually accompanied by a marked sense of discomfort or pain in the leg or other affected body part. The prevalence of RLS is estimated at 2.7–5% of adults and it is more common in women. The treatment of RLS with levodopa has been reported thus a systematic synthesis of evidence is necessary to evaluate the effectiveness and safety of levodopa for RLS. Method: It was a systematic review of randomized or quasi-randomized, double blind trials on levodopa. Relief of restless legs symptoms marked on a validated scale, subjective sleep quality, sleep quality measured by night polysomnography and actigraphy, quality of life measured by subjective measures, adverse events associated with the treatments. Results: Nine eligible clinical trials were included. The subjective analyses of these studies showed controversial results, although the objective analyses showed that treatment group had a statistically significant improvement of periodic leg movement (PLM) index, favoring the treatment group. The most commonly adverse event seen was gastrointestinal symptoms. Conclusions: The short-term treatment with levodopa was demonstrated effective and safety for PLM, but there was only few trials assessing long-term treatment and the augmentation phenomenon in RLS. Further long-term randomized controlled trials using standard follow-up measurements as the International RLS Study Group Rating Scale are necessary. doi:10.1016/j.clinph.2008.07.264
16. Swallowing dysfunction in hereditary neuropathy with liability to pressure palsies—P.J. Lorenzoni 1, J. Cardoso 1, C.S.K. Kay 1, E.A. Fugmann 1, W. Marques Jr 2, R.H. Scola 1, L.C. Werneck 1 (1 Universidade Federal do Paraná, Curitiba, Brazil, 2 Universidade de São Paulo, Ribeirão Preto, Brazil) We report a 41-year-old-man who presented with a history of repetitive peripheral nerve paralysis since infancy and had started to experience sudden episodes of severe dysphagia during the previous year. Videoendoscopic and fluoroscopic examination revealed pharyngeal dysfunction. Barium esophagography was compatible with symmetrical hypotonia of the esophagus. Hereditary neuropathy with liability to pressure palsies (HNPP) was diagnosed by electrophysiological and molecular genetic testing. We suggest that swallowing problems may be a clinical manifestation of HNPP. doi:10.1016/j.clinph.2008.07.265
17. Working-out practitioners and swimmers, men and women, do they sleep well?—R. Olimpio, P. Papassidero, R. Pietrobom, A.J. Godoy (University of Ribeirão Preto, Ribeirão Preto, Brazil) Objective: Evaluate the effects of working-out and swimming on different stages of sleep, for men and women. Method: Forty-seven students answered several questions, on the characteristics of a typical sleep night. The volunteers aged
e5
16–25 years-old. Ten men and 12 women worked-out regularly. Among the swimmers, 13 were men and 12 women. Results: Considering the total length of sleep, 61.5% of male and 58.3% of female swimmers sleep more then 8 hours every day. For those who work out, 40.0% of men and 41.7% sleep as much. Taking into account the minutes to fall asleep, 30.8% of male swimmers and 10.0% of men who work-out need less then 15 min to sleep. Seventyfive per cent of the female swimmers and 61.5% of the male swimmers reported waking in the morning ‘‘tired. In the case of those who work-out, 40.0% of the men and 33.3% of the women mentioned that sensation. Conclusion: Our data support the idea that a certain percentage of male swimmers take a short time to fall asleep. The same is not true for the men who work-out. However, 61.5% of all male swimmers reported tireness in the morning. The percentage of women swimmers reporting such feeling was even greater (75%). Women who work-out take a short time to fall asleep. Significance: One can advise women who have problems to fall asleep, to swim. On the other hand, working-out is a good practice for those who refer waking in the morning tired, either men or women. doi:10.1016/j.clinph.2008.07.266
18. Influence of the hepatic cirrhosis severity on sleep parameters—V.V. Teodoro 1, L.M. Lucchesi 1, M. Bragagnolo Jr 2, D. Cavignolli 1, M. DE Mello Kondo 2, T. Tufik 1 (1 Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil, 2 Department of Gastroenterology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil) Objective: To assess a possible influence of the hepatic cirrhosis severity on sleep parameters. Methods: Forty-two cirrhotic patients treated at the hepatology outpatient service of Hospital São Paulo (UNIFESP/EPM) and 24 healthy volunteers were submitted to an all night polysomnographic evaluation. The severity of the illness was assessed by the Child-Turcotte-Pugh (CTP) classification. Results: The patients were classified as Child A (16 individuals) Child B (17 individuals) and Child C (9 individuals). The polysomnographic findings showed lower sleep efficiency (p < 0.01), as well as an increase in the REM sleep latency (p < 0.01) and a lower REM sleep percentage (p < 0.01) in the cirrhotic group when compared with the control group. There was a difference among CTP groups in regard to REM sleep percentage, significantly lower in group C when compared to group B (p < 0.02) and group A (p < 0.03) and also a negative correlation between the Child Pugh score and REM sleep percentage (r = 0.47). Conclusions: The findings suggest that cirrhotic patients present worse sleep quality than healthy controls and that the subjects with more accentuated liver failure have lower REM sleep percentage. doi:10.1016/j.clinph.2008.07.267
19. Assessment of a possible relationship between P300 latency and ammonia arterial levels in cirrhotic patients—L.M. Lucchesi 1, V.V. Teodoro 1, M. Bragagnolo Jr 1, M. Kondo 2, S. Tufik 1 (1 Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil, 2 Department of Gastroenterology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil) Objective: To assess a possible relationship between P300 latency and ammonia arterial levels in cirrhotic patients.
15. Levodopa for idiopathic restless legs syndrome: Systematic review—C.F. Conti, M.M. Oliveira, J.S. Valbuza, R.B. Andriolo, N.A. Atallah, L.B.C. Carvalho, L.B.F. Prado, G.F. Prado (Neuro-Sono, Department of Neurology and Department of Emergency and Evidence, Federal University of São Paulo – UNIFESP, São Paulo, Brazil) Background: Restless Legs Syndrome (RLS) is a sensory motor disorder characterized by a distressing urge to move the legs and sometimes also other parts of the body usually accompanied by a marked sense of discomfort or pain in the leg or other affected body part. The prevalence of RLS is estimated at 2.7–5% of adults and it is more common in women. The treatment of RLS with levodopa has been reported thus a systematic synthesis of evidence is necessary to evaluate the effectiveness and safety of levodopa for RLS. Method: It was a systematic review of randomized or quasi-randomized, double blind trials on levodopa. Relief of restless legs symptoms marked on a validated scale, subjective sleep quality, sleep quality measured by night polysomnography and actigraphy, quality of life measured by subjective measures, adverse events associated with the treatments. Results: Nine eligible clinical trials were included. The subjective analyses of these studies showed controversial results, although the objective analyses showed that treatment group had a statistically significant improvement of periodic leg movement (PLM) index, favoring the treatment group. The most commonly adverse event seen was gastrointestinal symptoms. Conclusions: The short-term treatment with levodopa was demonstrated effective and safety for PLM, but there was only few trials assessing long-term treatment and the augmentation phenomenon in RLS. Further long-term randomized controlled trials using standard follow-up measurements as the International RLS Study Group Rating Scale are necessary. doi:10.1016/j.clinph.2008.07.264
16. Swallowing dysfunction in hereditary neuropathy with liability to pressure palsies—P.J. Lorenzoni 1, J. Cardoso 1, C.S.K. Kay 1, E.A. Fugmann 1, W. Marques Jr 2, R.H. Scola 1, L.C. Werneck 1 (1 Universidade Federal do Paraná, Curitiba, Brazil, 2 Universidade de São Paulo, Ribeirão Preto, Brazil) We report a 41-year-old-man who presented with a history of repetitive peripheral nerve paralysis since infancy and had started to experience sudden episodes of severe dysphagia during the previous year. Videoendoscopic and fluoroscopic examination revealed pharyngeal dysfunction. Barium esophagography was compatible with symmetrical hypotonia of the esophagus. Hereditary neuropathy with liability to pressure palsies (HNPP) was diagnosed by electrophysiological and molecular genetic testing. We suggest that swallowing problems may be a clinical manifestation of HNPP. doi:10.1016/j.clinph.2008.07.265
17. Working-out practitioners and swimmers, men and women, do they sleep well?—R. Olimpio, P. Papassidero, R. Pietrobom, A.J. Godoy (University of Ribeirão Preto, Ribeirão Preto, Brazil) Objective: Evaluate the effects of working-out and swimming on different stages of sleep, for men and women. Method: Forty-seven students answered several questions, on the characteristics of a typical sleep night. The volunteers aged
e5
16–25 years-old. Ten men and 12 women worked-out regularly. Among the swimmers, 13 were men and 12 women. Results: Considering the total length of sleep, 61.5% of male and 58.3% of female swimmers sleep more then 8 hours every day. For those who work out, 40.0% of men and 41.7% sleep as much. Taking into account the minutes to fall asleep, 30.8% of male swimmers and 10.0% of men who work-out need less then 15 min to sleep. Seventyfive per cent of the female swimmers and 61.5% of the male swimmers reported waking in the morning ‘‘tired. In the case of those who work-out, 40.0% of the men and 33.3% of the women mentioned that sensation. Conclusion: Our data support the idea that a certain percentage of male swimmers take a short time to fall asleep. The same is not true for the men who work-out. However, 61.5% of all male swimmers reported tireness in the morning. The percentage of women swimmers reporting such feeling was even greater (75%). Women who work-out take a short time to fall asleep. Significance: One can advise women who have problems to fall asleep, to swim. On the other hand, working-out is a good practice for those who refer waking in the morning tired, either men or women. doi:10.1016/j.clinph.2008.07.266
18. Influence of the hepatic cirrhosis severity on sleep parameters—V.V. Teodoro 1, L.M. Lucchesi 1, M. Bragagnolo Jr 2, D. Cavignolli 1, M. DE Mello Kondo 2, T. Tufik 1 (1 Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil, 2 Department of Gastroenterology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil) Objective: To assess a possible influence of the hepatic cirrhosis severity on sleep parameters. Methods: Forty-two cirrhotic patients treated at the hepatology outpatient service of Hospital São Paulo (UNIFESP/EPM) and 24 healthy volunteers were submitted to an all night polysomnographic evaluation. The severity of the illness was assessed by the Child-Turcotte-Pugh (CTP) classification. Results: The patients were classified as Child A (16 individuals) Child B (17 individuals) and Child C (9 individuals). The polysomnographic findings showed lower sleep efficiency (p < 0.01), as well as an increase in the REM sleep latency (p < 0.01) and a lower REM sleep percentage (p < 0.01) in the cirrhotic group when compared with the control group. There was a difference among CTP groups in regard to REM sleep percentage, significantly lower in group C when compared to group B (p < 0.02) and group A (p < 0.03) and also a negative correlation between the Child Pugh score and REM sleep percentage (r = 0.47). Conclusions: The findings suggest that cirrhotic patients present worse sleep quality than healthy controls and that the subjects with more accentuated liver failure have lower REM sleep percentage. doi:10.1016/j.clinph.2008.07.267
19. Assessment of a possible relationship between P300 latency and ammonia arterial levels in cirrhotic patients—L.M. Lucchesi 1, V.V. Teodoro 1, M. Bragagnolo Jr 1, M. Kondo 2, S. Tufik 1 (1 Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil, 2 Department of Gastroenterology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil) Objective: To assess a possible relationship between P300 latency and ammonia arterial levels in cirrhotic patients.