Control of medically refractory restless legs syndrome with intrathecal morphine: case report.
OBJECTIVE
Restless legs syndrome is now widely recognized and is usually successfully treated with medication. Occasionally, it may be severe and refractory to medication. Intrathecal opiates have been previously described to be useful in this situation in a single report.


METHODS
We report the successful use of low-dose intrathecal morphine in a severe case of restless legs syndrome refractory to medication.


METHODS
The surgery was complicated by extreme restlessness in the recovery room resulting in withdrawal or breakage of the catheter on multiple occasions. Relief of symptoms was lost with each catheter malfunction. We describe the possible origin of this complication and a solution to the problem resulting in the successful control of symptoms for 7 months since the last surgery.


CONCLUSIONS
Intrathecal opiates for restless legs syndrome are currently considered investigational, but we hope, with this second report of the efficacy of low-dose intrathecal narcotics in this condition, to stimulate further investigation of this treatment modality.
Ross
Donald A
DA
Medford Neurological Clinic, Medford, Oregon 97504, USA. drdoom867@yahoo.com
Narus
Michael S
MS
Nutt
John G
JG
D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D006801:Humans; D007278:Injections, Spinal / Q000379:methods*; D008297:Male; D009020:Morphine / Q000008:administration & dosage*; D012148:Restless Legs Syndrome / Q000188:drug therapy*
D000701:Analgesics, Opioid; D009020:Morphine