title: Post-stroke restless leg syndrome and periodic limb movements in sleep.
abstract: OBJECTIVE
  Primary restless leg syndrome (RLS) and periodic limb movements in sleep (PLMS) frequently co-exist, obscuring the boundaries between the two conditions. In such instances, a study of secondary cases with focal lesions such as post-stroke RLS and PLMS (psRLS and psPLMS, respectively) can be helpful in identifying characteristics of the individual conditions.
  
  
  METHODS
  Patients who had suffered strokes and who subsequently developed psRLS or psPLMS were recruited. To determine the overall features of psRLS/PLMS, historical cases were selected from the literature. All cases with either psRLS or psPLMS alone were further analyzed to elucidate the distinctive pathomechanisms of the two conditions.
  
  
  RESULTS
  Six patients with either psRLS or psPLMS were recruited from our hospital; two patients had both conditions contemporaneously. The literature contains details on 30 cases of psRLS or psPLMS. The causative lesion was most frequently located in the pons. We found that psRLS was more often bilateral, and usually detected later in time. Lesions in both the pontine base and tegmentum (together) were associated with unilateral psPLMS, whereas lesions in the corona radiata and adjacent basal ganglia were associated with bilateral RLS. Lesions confined to the corona radiata resulted in either unilateral or bilateral RLS.
  
  
  CONCLUSIONS
  The observed differences in the clinical and radiological features of psRLS and psPLMS suggest that the pathophysiologies of the two conditions are distinct. Further research is needed to understand the pathophysiologies of primary RLS and PLMS.
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: H G
authors.initials: HG
authors.lastname: Woo
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: D
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: K J
authors.initials: KJ
authors.lastname: Hwang
authors.affiliation: Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: T-B
authors.initials: TB
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D017286:Polysomnography / Q000639:trends; D011149:Pons / Q000000981:diagnostic imaging; D012148:Restless Legs Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012890:Sleep / Q000502:physiology*; D020521:Stroke / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*
keywords: laterality; periodic limb movements in sleep; pons; restless legs syndrome; stroke