A case of a patient with both chorea and restless legs syndrome.
The patient was a 44-yr-old man with end-stage renal disease who had developed chorea as a result of hypoglycemic injury to the basal ganglia and thalamus and who was subsequently diagnosed with depression and restless legs syndrome (RLS). For proper management, the presence of a complex medical condition including two contrasting diseases, chorea and RLS, had to be considered. Tramadol improved the pain and dysesthetic restlessness in his feet and legs, and this was gradually followed by improvements in his depressed mood, insomnia, lethargy, and feelings of hopelessness. This case suggests that the dopaminergic system participates intricately with the opioid, serotoninergic, and noradrenergic systems in the pathophysiology of RLS and pain and indirectly of depression and insomnia.
Shin
Yoon-Kyung
YK
Department of Psychiatry, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea.
Hong
Seung-Chul
SC
Ihn
Yon Kwon
YK
Jeong
Jong-Hyun
JH
Han
Jin-Hee
JH
Lee
Sung-Pil
SP
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D002819:Chorea / Q000150:complications* / Q000473:pathology; D015283:Citalopram / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D012148:Restless Legs Syndrome / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014147:Tramadol / Q000627:therapeutic use
D000701:Analgesics, Opioid; D018726:Anti-Dyskinesia Agents; D015283:Citalopram; D006220:Haloperidol; D017367:Selective Serotonin Reuptake Inhibitors; D014147:Tramadol