Document Detail


Thermal hypoaesthesia differentiates secondary restless legs syndrome associated with small fibre neuropathy from primary restless legs syndrome.
MedLine Citation:
PMID:  20194142     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study aimed to assess thermal and mechanical perception and pain thresholds in primary idiopathic restless legs syndrome and secondary restless legs syndrome associated with small fibre neuropathy. Twenty-one patients (age: 53.4 + or - 8.4, n = 3, male) with primary restless legs syndrome and 13 patients (age: 63.0 + or - 8.2, n = 1, male) with secondary restless legs syndrome associated with small fibre neuropathy were compared with 20 healthy subjects (age: 58.0 + or - 7.0; n = 2, male). Differential diagnosis of secondary restless legs syndrome associated with small fibre neuropathy was based on clinical symptoms and confirmed with skin biopsies in all patients. A comprehensive quantitative sensory testing protocol encompassing thermal and mechanical detection and pain thresholds, as devised by the German Research Network on Neuropathic Pain, was performed on the clinically more affected foot between 2 pm and 1 am when restless legs syndrome symptoms were present in all patients. Patients with primary restless legs syndrome showed hyperalgesia to blunt pressure (P < 0.001), pinprick (P < 0.001) and vibratory hyperaesthesia (P < 0.001). Patients with secondary restless legs syndrome associated with small fibre neuropathy showed thermal hypoaesthesia to cold (Adelta-fibre mediated) and warm (C-fibre mediated) (all P < 0.001) and hyperalgesia to pinprick (P < 0.001). Static mechanical hyperalgesia in primary and secondary restless legs syndrome is consistent with the concept of central disinhibition of nociceptive pathways, which might be induced by conditioning afferent input from damaged small fibre neurons in secondary restless legs syndrome.
Authors:
Cornelius G Bachmann; Roman Rolke; Uta Scheidt; Christine Stadelmann; Martin Sommer; Goran Pavlakovic; Svenja Happe; Rolf-Detlef Treede; Walter Paulus
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-28
Journal Detail:
Title:  Brain : a journal of neurology     Volume:  133     ISSN:  1460-2156     ISO Abbreviation:  Brain     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-04-13     Revised Date:  2011-05-18    
Medline Journal Info:
Nlm Unique ID:  0372537     Medline TA:  Brain     Country:  England    
Other Details:
Languages:  eng     Pagination:  762-70     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Neurophysiology, Georg August University, Robert Koch Strasse 40, D-37075 Goettingen, Germany. cbachma@gwdg.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Cold Temperature
Female
Hot Temperature
Humans
Male
Middle Aged
Pain / physiopathology*
Pain Measurement
Pain Threshold
Peripheral Nervous System Diseases / diagnosis*,  pathology,  physiopathology*
Photoperiod
Physical Stimulation
Pressure
Restless Legs Syndrome / diagnosis*,  pathology,  physiopathology*
Sensory Thresholds
Skin / pathology
Touch Perception / physiology*
Vibration
Comments/Corrections
Comment In:
Brain. 2011 Apr;134(Pt 4):e167; author reply e168   [PMID:  21059747 ]

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