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17-06-2024 | Case Report

Complete resolution of restless legs syndrome following ischemic stroke of the right middle cerebral artery

Authors: Augustin Moreau, Izzie Jacques Namer, Laurent Tatu, Valérie Wolff, Patrice Bourgin, Elisabeth Ruppert

Published in: Sleep and Biological Rhythms

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Abstract

Stroke-related restless legs syndrome (sRLS) is an emerging clinical entity, with a clear relationship between stroke and the occurrence of restless legs syndrome (RLS). Dopamine dysregulation has been observed in sRLS of the lenticulostriate region with increased dopamine precursor and decreased dopamine transporter. The aim of this work is to explore an original case of regressive RLS following stroke. Anatomical (MRI) and functional (18F-FDG PET; 18F- FDOPA PET; 123I-FP-CIT SPECT) brain imaging was performed in our patient. A 63 year-old woman experienced complete resolution of longstanding restless legs syndrome (RLS) after a right middle cerebral artery stroke (left faciobrachial sensorimotor deficit), efficiently treated with intravenous thrombolysis. Having had RLS for 14 years, she reported complete symptom relief within four days post-stroke. 2 year follow-up confirmed sustained improvement. In our patient, functional dopaminergic imaging revealed an overall normal dopaminergic tone. This case contradicts the more commonly reported scenario of sRLS where stroke leads to the onset or worsening of RLS. The pathophysiology of RLS remains unclear and in the absence of clear biomarkers for RLS, small lesion models in humans can provide valuable insights to a better understanding of this disease.
Literature
Metadata
Title
Complete resolution of restless legs syndrome following ischemic stroke of the right middle cerebral artery
Authors
Augustin Moreau
Izzie Jacques Namer
Laurent Tatu
Valérie Wolff
Patrice Bourgin
Elisabeth Ruppert
Publication date
17-06-2024
Publisher
Springer Nature Singapore
Published in
Sleep and Biological Rhythms
Print ISSN: 1446-9235
Electronic ISSN: 1479-8425
DOI
https://doi.org/10.1007/s41105-024-00534-z