Síndrome das pernas inquietas em pacientes com síndrome pós-poliomielite
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Data
2014-04-30
Autores
Marin, Luis Fabiano [UNIFESP]
Orientadores
Prado, Gilmar Fernandes do [UNIFESP]
Tipo
Tese de doutorado
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Objetivo: Investigar a prevalência da síndrome das pernas inquietas (SPI) em pacientes com a síndrome pós-poliomielite (SPP) e avaliar os aspectos clínicos e demográficos, assim como a gravidade da SPI na população estudada. Métodos: Cento e dezenove pacientes com diagnóstico de SPP do ambulatório de Pós-poliomielite do Setor de Investigação de doenças Neuromusculares da Universidade Federal de São Paulo foram investigados para SPI de acordo com os critérios diagnósticos estabelecidos pelo Grupo de Estudos Internacional da SPI (IRLSSG). A gravidade da SPI foi avaliada pela Escala de Gravidade da SPI do Grupo Internacional de Estudos da SPI (IRLS). Os pacientes foram avaliados quanto a dados demográficos, comorbidades clínicas, sonolência diurna, exames laboratoriais (hemograma, creatinina, glicose, dosagem de hormônio estimulante da tireoide, creatinofosforoquinase e ferritina) e quanto à localização dos sintomas da SPI. Resultados: A prevalência da SPI foi 36% (n=43; 32 mulheres e 11 homens). Houve concomitância entre as idades de início da SPI (mediana=41 anos) e da SPP (mediana=41 anos), não havendo diferença quanto à idade (p=0,999). A localização dos sintomas da SPI foi mais frequente nas pernas (84%), seguido de coxas (58%) e pés (26%). A gravidade da SPI apresentou mediana de 23 (20-28). Baixa escolaridade, sonolência diurna e depressão foram fatores preditivos para SPI. Conclusão: A prevalência de SPI neste grupo de pacientes foi maior que a esperada para a população geral. Um alto grau de concordância foi encontrado entre o início dos sintomas da SPI e da SPP. Este estudo sugere que a SPI deve ser investigada em indivíduos com SPP que apresentam queixas motoras e/ou sensitivas nos membros inferiores. Futuros estudos são necessários para investigar melhor a relação clínica e fisiopatológica entre a SPP e a SPI.
Background: To investigate the prevalence of restless legs syndrome (RLS) in patients with post-polio syndrome (PPS) and to evaluate clinical and demographic aspects, as well as, the severity of LS in this population. Methods: One hundred and nineteen patients with PPS from the outpatient clinic of Post-polio in the Neuromuscular Disorder Unit at the Universidade Federal de Sao Paulo were investigated for RLS based on the diagnostic criteria established by the International RLS Study Group (IRLSSG). The severity of RLS was measured by the IRLSSG rating scale. We assessed demographics, medical comorbidities, daytime sleepiness, laboratory tests (blood count, creatinine, glucose, serum thyroid-stimulating hormone, creatinofosforoquinase and ferritin) and the location of RLS symptoms. Results: The prevalence of RLS was 36% (n = 43, 32 women and 11 men). The ages of onset of RLS (median = 41 years) and SPP (median = 41 years) were concurrent, with no difference in age (p = 0,999). RLS symptoms had more frequent location in the legs (84%), followed by thighs (58%) and legs (26%). The severity of RLS had a median of 23 (20-28). Low educational achievement, daytime sleepiness and depression were predictive factors for RLS. Conclusions: The prevalence of RLS in this group of patients was higher than expected for the general population. A high degree of concordance was found between the onset of symptoms of RLS and PPS. This study suggests that RLS should be investigated in individuals with PPS who have motor and /or sensory complaints in lower limbs. Further studies are needed to improve the clinical and pathophysiological understanding of this relationship.
Background: To investigate the prevalence of restless legs syndrome (RLS) in patients with post-polio syndrome (PPS) and to evaluate clinical and demographic aspects, as well as, the severity of LS in this population. Methods: One hundred and nineteen patients with PPS from the outpatient clinic of Post-polio in the Neuromuscular Disorder Unit at the Universidade Federal de Sao Paulo were investigated for RLS based on the diagnostic criteria established by the International RLS Study Group (IRLSSG). The severity of RLS was measured by the IRLSSG rating scale. We assessed demographics, medical comorbidities, daytime sleepiness, laboratory tests (blood count, creatinine, glucose, serum thyroid-stimulating hormone, creatinofosforoquinase and ferritin) and the location of RLS symptoms. Results: The prevalence of RLS was 36% (n = 43, 32 women and 11 men). The ages of onset of RLS (median = 41 years) and SPP (median = 41 years) were concurrent, with no difference in age (p = 0,999). RLS symptoms had more frequent location in the legs (84%), followed by thighs (58%) and legs (26%). The severity of RLS had a median of 23 (20-28). Low educational achievement, daytime sleepiness and depression were predictive factors for RLS. Conclusions: The prevalence of RLS in this group of patients was higher than expected for the general population. A high degree of concordance was found between the onset of symptoms of RLS and PPS. This study suggests that RLS should be investigated in individuals with PPS who have motor and /or sensory complaints in lower limbs. Further studies are needed to improve the clinical and pathophysiological understanding of this relationship.
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MARIN, Luis Fabiano. Síndrome das pernas inquietas em pacientes com síndrome pós-poliomielite. 2014. Tese (Doutorado) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2014.