title: Restless legs syndrome associated with diminished cardiopulmonary compliance and lumbar spinal stenosis--a motor concomitant of "Vesper's curse".
abstract: Lumbosacral and associated leg pain and paresthesias arousing patients from a sound sleep, or Vesper's curse, has been previously reported. An increase in right atrial filling pressure reflected in elevated paraspinal venous volumes within the reduced confines of a stenotic lumbar spine has been cited as the cause of this syndrome. Six cases of concomitant nocturnal calf cramps and fasciculations associated with the night pain and paresthesias are reported. In all cases a reduction in cardiopulmonary compliance was noted, with clinical and electromyographic evidence of paraspinal and lower extremity fasciculations increasing at night. Symptoms were relieved by assuming an erect or semi-reclining sleep position. In five of the six reported cases of lumbar spinal stenosis, spondylolisthesis was also present. The motor equivalent of Vesper's curse was evaluated by electromography, evoked potentials, CAT scan, and myelography. The multiple factors involved in the pathomechanics and pathophysiology of lumbar radiculopathy, and spinal stenosis and the role of the paravertebral plexus of veins are reviewed as they relate to the genesis of the restless legs syndrome.
authors.affiliation: Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Royal Oak, MI 48072.
authors.forename: M M
authors.initials: MM
authors.lastname: LaBan
authors.forename: S L
authors.initials: SL
authors.lastname: Viola
authors.forename: A F
authors.initials: AF
authors.lastname: Femminineo
authors.forename: R S
authors.initials: RS
authors.lastname: Taylor
mesh_terms: D000368:Aged; D004576:Electromyography; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D009192:Myelography; D012148:Restless Legs Syndrome / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D013130:Spinal Stenosis / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed