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Electrophysiological pattern of involuntary limb movements in the restless legs syndrome
Author(s) -
Trenkwalder Claudia,
Bucher Stefan F.,
Oertel Wolfgang H.
Publication year - 1996
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(199602)19:2<155::aid-mus5>3.0.co;2-d
Subject(s) - disinhibition , restless legs syndrome , electromyography , electrophysiology , medicine , reflex , brainstem , physical medicine and rehabilitation , h reflex , proprioception , psychology , anesthesia , neuroscience , neurology
Patients with restless legs syndrome (RLS) suffer from involuntary limb movements during the day. We studied these leg movements in 18 idiopathic ( n = 8) and uremic ( n = 10) patients at rest. Electromyographically measured muscle contractions were preceded by sensory discomfort in all patients. The mean duration of the contractions ranged between 0.67 and 5.71 s with a mean frequency of 244 epochs of muscle activity per hour. Seven of 18 patients showed a constant order of recruitment with propagation of muscle activity up or down spinal segments (L3 to S1 and vice versa). No difference in electrophysiologically recorded patterns was observed between patients with idiopathic and uremic RLS. We suggest a brainstem disinhibition phenomenon as the pathological mechanism that activates a spinal generator. The spinal origin of the involuntary limb movements in patients with RLS is confirmed by the long duration of jerks, the recruitment characteristics, and the periodicity of the jerks. No jerk could be elicited by sensory reflexes. © 1996 John Wiley & Sons, Inc.