Epidural Spinal Cord Stimulation: A Novel Therapy in the Treatment of Restless Legs Syndrome.
BACKGROUND
We report a unique finding of a patient whose restless legs syndrome (RLS) symptoms abated after the placement of a spinal cord stimulator for chronic neuropathic pain. RLS is a common disorder, with many patients unable to find sufficient relief from their symptoms.


METHODS
A patient diagnosed with neuropathic pain who also suffered from RLS symptoms despite medication therapy underwent implantation of a spinal cord stimulator after a successful trial. This patient was interviewed formally about his RLS symptoms immediately before his procedure and at 6 weeks, 6 months, and 2.5 years after the procedure. The patient also completed the International Restless Legs Syndrome Scale questionnaire to objectively quantify the severity of his symptoms. Finally, the patient kept a 5-day journal detailing when the stimulator was in use. The patient reported subjective symptomatic improvement in his RLS symptoms with improved sleep quality and quantity, in addition to improvement in his back pain. The patient's score on the International Restless Legs Syndrome Scale improved after implantation from 33 to 0 on a 40-point scale. Moreover, when asked to keep a journal record of his stimulator use, the patient noted that he only used the stimulator before going to bed to help his RLS symptoms and no longer required any medication for his previous RLS symptoms.


CONCLUSIONS
Epidural stimulation may be an additional, alternative, or novel therapy in the treatment of RLS.
Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Marshall T
MT
Holland
Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Leigh A
LA
Rettenmaier
Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Oliver E
OE
Flouty
Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Teri R
TR
Thomsen
Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Nivedita U
NU
Jerath
Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. Electronic address: chandan-reddy@uiowa.edu.
Chandan G
CG
Reddy
D000368:Aged; D004824:Epidural Space / Q000000981:diagnostic imaging / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012148:Restless Legs Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D062187:Spinal Cord Stimulation; D016896:Treatment Outcome
Epidural; Failed back syndrome; Periodic limb movements; Restless legs syndrome; Spinal cord stimulation