title: Epilepsy and restless legs syndrome.
abstract: Restless legs syndrome (RLS) is a common neurological movement disorder occurring in approximately 10% of the general population. The prevalence of moderately severe RLS is 2.7% overall (3.7% for women and 1.7% for men). Epilepsy is also a common neurological disorder with significant associated morbidity and impact on quality of life. We evaluated the severity and frequency of primary RLS in patients with localization-related temporal lobe epilepsy (TLE) and investigated the role of prodromal RLS symptoms as a warning sign and lateralizing indicator.
  
  
  
  All epilepsy patients seen in the outpatient clinic were screened for movement disorders from 2005 to 2015. Ninety-eight consecutive patients with localization-related TLE (50 right TLE and 48 left TLE) who met inclusion criteria were seen in the outpatient clinic. The control group consisted of 50 individuals with no history or immediate family history of epilepsy. Each patient was evaluated with the International Restless Legs Study Group (IRLSSG) questionnaire, NIH RLS diagnostic criteria, ferritin level, and comprehensive sleep screening including polysomnography. Furthermore, patients with obstructive sleep apnea or a definite cause of secondary restless legs syndrome such as low serum ferritin or serum iron levels were also excluded from the study.
  
  
  
  There was a significant association between the type of epilepsy and whether or not patients had RLS χ2(1)=10.17, p<.01, using the χ2Goodness of Fit Test. Based on the odds ratio, the odds of patients having RLS were 4.60 times higher if they had right temporal epilepsy than if they had left temporal epilepsy, serving as a potential lateralizing indicator. A prodromal sensation of worsening RLS occurred in some patients providing the opportunity to intervene at an earlier stage in this subgroup.
  
  
  
  We identified frequent moderate to severe RLS in patients with epilepsy. The frequency of RLS was much more common than would typically be seen in patients of similar age. The restlessness was typically described as moderately severe. The RLS symptoms were more common and somewhat more severe in the right TLE group than the left TLE group.
authors.affiliation: The Sleep Program, The Clinical Neurophysiology Laboratories, Alabama Neurology and Sleep Medicine, Tuscaloosa, AL, United States; Department of Psychology, The University of Alabama, Tuscaloosa, AL, United States; Neurotexion, LLC, Tuscaloosa, AL, United States. Electronic address: jgeyer@nctpc.com.
authors.forename: James D
authors.initials: JD
authors.lastname: Geyer
authors.affiliation: The Sleep Program, The Clinical Neurophysiology Laboratories, Alabama Neurology and Sleep Medicine, Tuscaloosa, AL, United States; ReflexARC, Tuscaloosa, AL, United States.
authors.forename: Emery E
authors.initials: EE
authors.lastname: Geyer
authors.affiliation: Department of Psychology, The University of Alabama, Tuscaloosa, AL, United States.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Fetterman
authors.affiliation: Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Carney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D011788:Quality of Life; D012148:Restless Legs Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D012720:Severity of Illness Index; D012890:Sleep; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Aura; Prodrome; Restless legs syndrome; Temporal lobe epilepsy