Open AccessLeg restlessness preceding the onset of motor symptoms of Parkinson disease
Author(s) -
Keisuke Suzuki,
Hiroaki Fujita,
Yuji Watanabe,
Takeo Matsubara,
Tomoko Kadowaki,
Hirotaka Sakuramoto,
Mai Hamaguchi,
Narihiro Nozawa,
Koichi Hirata
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000016892
Subject(s) - parkinsonism , medicine , exacerbation , motor symptoms , parkinson's disease , pediatrics , restless legs syndrome , disease , psychiatry , neurology
Abstract Patients with Parkinson disease (PD) often show restless legs syndrome (RLS), leg motor restlessness (LMR) and other leg restlessness (OLR) related to sensorimotor symptoms. Here, we describe 5 patients who presented with leg restlessness as an early manifestation of PD. In case 1, the patient had leg restlessness that was not LMR or RLS and preceded the onset of motor symptoms by 1 year. In case 2, LMR preceded motor symptoms by 2 years. Case 3 had unilateral RLS symptoms on the left side of the body for 33 years. Two and a half years after the spread of RLS symptoms to the right leg with increased frequency of left-sided RLS symptoms, the patient developed PD at the age of 58 years. In cases 4 and 5, RLS symptoms preceded motor symptoms by 3 months and 1 month, respectively. All patients developed Parkinsonism within 3 years (median, 1.0 year; range 0.083–2.5 years) after initial onset or exacerbation of leg restlessness. All patients had frequent leg restlessness symptoms (6–7 days per week). In our series, the preceding leg restlessness was unilateral and confined to the dominant side of the subsequent Parkinsonism, or preceding leg restlessness was bilateral but dominant on the dominant side of the subsequent Parkinsonism. Clinicians should be aware that late-onset leg restlessness (>50 years of age) including RLS, LMR, and OLR, particularly if frequent and asymmetrical, can be an early nonmotor manifestation of PD.