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Association between restless legs syndrome and peripheral neuropathy: A systematic review and meta‐analysis
Author(s) -
JiménezJiménez Félix Javier,
AlonsoNavarro Hortensia,
GarcíaMartín Elena,
Agúndez José A.G.
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14840
Subject(s) - medicine , restless legs syndrome , peripheral neuropathy , confidence interval , meta analysis , disease , polyneuropathy , gastroenterology , diabetes mellitus , neurology , endocrinology , psychiatry
Background and purpose The coexistence of peripheral neuropathy (PN) and restless legs syndrome (RLS) or Willis–Ekbom disease is relatively frequent, but its prevalence has shown a high variability across studies. In addition, several reports have shown data suggesting the presence of PN in patients with idiopathic RLS. Methods A search was undertaken using the PubMed, Embase and Web of Science Databases, from 1966 to 6 December 2020, crossing the search term ‘restless legs syndrome’ with ‘neuropathy’, ‘polyneuropathy’ (PNP) and ‘peripheral neuropathy’, and the references of interest for this topic were identified; a meta‐analysis was performed, according to PRISMA guidelines, and a calculation of pooled prevalences, where appropriate, was made using standard methods. Results Restless legs syndrome has been reported in 5.2%–53.7% of patients with PN (average 21.5%; 95% confidence interval 18.6%–24.5%), and PN has been reported in 0%–87.5% of patients with RLS (average 41.8%; 95% confidence interval 39.9%–43.6%), both being significantly more frequent than in controls. The heterogeneity across studies could be due to differences in the diagnostic criteria used for both RLS and PN. RLS is a frequent clinical complaint in patients with PN of different aetiologies, mainly diabetic PN, uraemic PNP, familial amyloid PNP, Charcot–Marie–Tooth disease and chronic dysimmune inflammatory PNP. Recent neurophysiological findings suggest the presence of small sensory fibre loss in patients diagnosed with idiopathic RLS, but it remains to be determined whether RLS associated with small sensory fibre loss and idiopathic RLS are different clinical entities. Conclusions Future studies including clinical and neurophysiological assessment and skin biopsy involving a large series of patients with PN and RLS are needed for a better understanding of the association between these two entities.