Open Access“Emplotted Narratives” and Structured “Behavioral Observations” Supporting the Diagnosis of Willis‐Ekbom Disease/Restless Legs Syndrome in Children with Neurodevelopmental Conditions
Author(s) -
Ipsiroglu Osman S.,
Beyzaei Nadia,
Berger Mai,
Wagner Alexandra L.,
Dhalla Sophia,
Garden Jennifer,
Stockler Sylvia
Publication year - 2016
Publication title -
cns neuroscience and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 69
eISSN - 1755-5949
pISSN - 1755-5930
DOI - 10.1111/cns.12564
Subject(s) - psychology , narrative , narrative review , disease , physical medicine and rehabilitation , clinical psychology , pediatrics , medicine , psychiatry , psychotherapist , philosophy , linguistics
Summary Background Willis‐Ekbom disease/restless legs syndrome ( WED / RLS ) seems to be a frequent cause of intractable chronic insomnia ( ICI ) but is under‐recognized in children/adolescents with neurodevelopmental conditions ( NDC s), as many patients do not have the ability to express the underlying “urge‐to‐move”. In light of this, we aim to develop a protocol for behavioral observations supporting the diagnosis of WED / RLS . Methods We investigated 26 pediatric patients (age 1–16 years, median 8) with NDC s, ICI and evidence of familial WED / RLS employing (1) “emplotted narratives” for description of the various “urge‐to‐move” presentations and (2) self‐description and “behavioral observations” during a “suggested clinical immobilization test” ( SCIT ). Results Parental narratives reflected typical WED / RLS ‐related “urge‐to‐move” symptoms during day‐, bed‐, and nighttime in all patients. Fifteen out of 26 patients could describe the “urge‐to‐move” during the SCIT . Ten out of 26 patients, unable to describe their symptoms due to cognitive disabilities, showed patterns of “relieving‐movements” upon observation. Sensory processing abnormalities were reported in all patients, with tactile sensitivities (26/26) (including shifted pain threshold) as the most common sensory domain. Conclusion “Emplotted narratives” and structured “behavioral observations” support recognition of familial WED / RLS associated movement patterns and provide a useful tool for the diagnosis of WED / RLS in children with NDCs in a clinical office setting.