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Restless legs syndrome in adolescents
Brain & Development xxx (2017) xxx–xxx www.elsevier.com/locate/braindev
Letter to the Editor Restless legs syndrome in adolescents Dear Sir, We have read with great interest an article of Per H. et al. [1] regarding prevalence of restless legs syndrome (RLS) in adolescents. The authors found the prevalence of the syndrome to be 2.9% in pupils aged 13–16 years. However, it should be also stressed that the diagnosis of the syndrome was based purely on a questionnaire and phone conversation. The family history of RLS and daytime sleepiness as well as the impact of the syndrome on academic performance was analysed too. In our survey carried out in Northern Poland, 2379 pupils aged 13–18 were investigated with questionnaire. At first 3,1% of the pupils met the diagnostic criteria for RLS, the further investigation however revealed RLSmimics in the majority of them (with positional discomfort and leg cramps to be most common) and finally the prevalence of the syndrome dropped to 1%. To support the diagnosis we performed actigraphy, finding abnormal PLMS (periodic leg movements in sleep) index in 80% of cases. The positive family history reached 80% and blood tests excluded secondary forms of RLS. We found similar median age at onset (10,96 y.), daytime sleepiness scale results and negative impact on academic performance. Surprisingly low RLS prevalence in the first-degree members in the article mentioned above (11,3%) should be further evaluated (secondary forms of RLS responsible for this result?). We suggest that every patient aged <18 years should be neurologically examined and interviewed face-to-face by a child neurologist specialist as misdiagnoses in this
age group are common. Moreover, actigraphy or polysomnography as well as biochemical blood tests should be taken into account to make proper diagnosis and to distinguish primary from secondary RLS. To our knowledge the awareness of the syndrome is still poor among child specialists and therefore we highly appreciate the aforesaid article as its academic value is significant. It proves that RLS is an important cause of insomnia and extended daytime sleepiness in adolescents.
Reference [1] Per H, Gunay N, Ismailogullari S, Oztop DB, Gunay O. Determination of restless legs syndrome prevalence in children aged 13–16 years in the provincial center of Kayseri. Brain Dev 2017;39:154–60.
Karolina Pienczk-Reclawowicz Ewa Pilarska Developmental Neurology Department, Medical University of Gdansk, Poland E-mail address: [email protected] Jaroslaw Slawek Department of Neurological and Psychiatric Nursing, Medical University of Gdan´sk, Poland Department of Neurology, St. Adalbert Hospital, Gdan´sk, Poland
http://dx.doi.org/10.1016/j.braindev.2017.04.004 0387-7604/Ó 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
Letter to the Editor Restless legs syndrome in adolescents Dear Sir, We have read with great interest an article of Per H. et al. [1] regarding prevalence of restless legs syndrome (RLS) in adolescents. The authors found the prevalence of the syndrome to be 2.9% in pupils aged 13–16 years. However, it should be also stressed that the diagnosis of the syndrome was based purely on a questionnaire and phone conversation. The family history of RLS and daytime sleepiness as well as the impact of the syndrome on academic performance was analysed too. In our survey carried out in Northern Poland, 2379 pupils aged 13–18 were investigated with questionnaire. At first 3,1% of the pupils met the diagnostic criteria for RLS, the further investigation however revealed RLSmimics in the majority of them (with positional discomfort and leg cramps to be most common) and finally the prevalence of the syndrome dropped to 1%. To support the diagnosis we performed actigraphy, finding abnormal PLMS (periodic leg movements in sleep) index in 80% of cases. The positive family history reached 80% and blood tests excluded secondary forms of RLS. We found similar median age at onset (10,96 y.), daytime sleepiness scale results and negative impact on academic performance. Surprisingly low RLS prevalence in the first-degree members in the article mentioned above (11,3%) should be further evaluated (secondary forms of RLS responsible for this result?). We suggest that every patient aged <18 years should be neurologically examined and interviewed face-to-face by a child neurologist specialist as misdiagnoses in this
age group are common. Moreover, actigraphy or polysomnography as well as biochemical blood tests should be taken into account to make proper diagnosis and to distinguish primary from secondary RLS. To our knowledge the awareness of the syndrome is still poor among child specialists and therefore we highly appreciate the aforesaid article as its academic value is significant. It proves that RLS is an important cause of insomnia and extended daytime sleepiness in adolescents.
Reference [1] Per H, Gunay N, Ismailogullari S, Oztop DB, Gunay O. Determination of restless legs syndrome prevalence in children aged 13–16 years in the provincial center of Kayseri. Brain Dev 2017;39:154–60.
Karolina Pienczk-Reclawowicz Ewa Pilarska Developmental Neurology Department, Medical University of Gdansk, Poland E-mail address: [email protected] Jaroslaw Slawek Department of Neurological and Psychiatric Nursing, Medical University of Gdan´sk, Poland Department of Neurology, St. Adalbert Hospital, Gdan´sk, Poland
http://dx.doi.org/10.1016/j.braindev.2017.04.004 0387-7604/Ó 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.