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Yıl:2020; Cilt: 57; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2020;57(4):299-302
Spinal Kord Lezyonu Olan Multipl Skleroz Hastalarında Huzursuz Bacaklar Sendromu/Willis Ekbom Hastalığı
G Sünter, Ö Kılınç, A Berk, S Akçabey, E Saldüz, H Öztürkçü, Dİ Günal, K Agan
Marmara Üniversitesi, İstanbul
Amaç: Daha önce yapılan birçok çalışmada, spinal kord hasarının Multipl Skleroz hastalarında Huzursuz Bacaklar Sendromu (HBS) görülme riski açısından önemli bir faktör olduğu belirtilmiştir. Bu çalışmada, relaps ve remisyonlarla seyreden multipl skleroz (RRMS) hastalarında uyku kalitesini, HBS prevalansını, depresyon varlığını, şiddetini ve bu parametrelerin servikal kord lezyonu ile olan ilişkisini araştırdık. Yöntem: Bu çalışma, Ekim 2013-Şubat 2014 tarihleri arasında, 93 hastanın MS tanısı ile izlendiği Marmara Üniversite Hastanesi multipl skleroz polikliniğinde gerçekleştirilmiştir. Bilgilendirilmiş onam formu alınmasından sonra hastaların demografik verileri, komorbiditeleri ve güncel tedavileri kaydedildi. Tüm hastalara, Pittsburgh Uyku Kalitesi İndeksi (PSQI), Epworth Uykululuk Ölçeği (ESS) ve Beck Depresyon Envanteri (BDI) uygulandı. Uyku kalitesi, HBS prevalansı ve depresyon şiddeti servikal kord lezyonu olan ve olmayan RRMS hastaları arasında karşılaştırıldı. Ayrıca, HBS ile uyku kalitesi, depresyon ve klinik dizabilite (EDSS) arasındaki ilişki değerlendirildi. Bulgular: Marmara Üniversitesi Hastanesi’nde RRMS tanısı ile izlenen 93 hastanın %72’si (n=67) kadın %28’i (n=26) erkekti. Hastaların %32’si (n=30) Uluslararası HBS çalışma grubu kılavuzuna göre HBS tanısı almaktaydı. Hastaların %57’sinde (n=53) patolojik spinal kord lezyonu bulunmaktaydı. HBS’u olan RRMS hastalarında HBS’u olmayanlara göre daha fazla oranda spinal kord lezyonu bulunmaktaydı (p=0,04). Uyku kalitesi, hem spinal kord lezyonu olan hem de HBS’u olan RRMS hastalarında istatistiksel açıdan anlamlı olarak daha düşük saptandı (p=0,031, p=0,0001). Sonuç: Özetle, RRMS hastalarında HBS’u gelişme riski spinal kord lezyonu varlığı ile artmaktadır. Uyku kalitesi hem HBS’u olan hem de spinal kord lezyonu olan bireylerde olmayanlara göre daha kötüdür. HBS’u tedavi edilebilir bir durum olması nedeniyle, tanının erken koyulup tedavi edilebilmesi hasta yaşam kalitesini arttırmak açısından önemlidir.
Restless Legs Syndrome/ Willis-Ekbom Disease in Multiple Sclerosis Patients with Spinal Cord Lesions
Introduction: Spinal cord lesions in Multiple Sclerosis (MS) patients are associated with a higher risk of restless legs syndrome (RLS). In this study, we investigated the prevalence of RLS, sleep quality, presence and severity of depression, and the relationship of these parameters with cervical cord lesions in patients with RRMS. Methods: This study was conducted in the outpatient multiple sclerosis clinic of Marmara University Hospital between October 2013 – February 2014, including 93 patients with the diagnosis of MS. After signing informed consent, demographic data, comorbidities and actual medication of the patients were collected. All patients completed the surveys including Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Beck Depression Inventory (BDI). Prevalence of HBS, sleep quality and depression severity were compared between those with and without cervical cord lesions. Furthermore, the relationship between RLS and sleep quality, depression and expanded disability status scale (EDSS) was assessed. Results: From overall patients, 72% were women (n=67) and 28% (n=26) were men. From all subjects, 32% (n=30) fulfilled IRLSSG diagnostic criteria. Fifty-seven percent of the patients (n=53) had pathological spinal cord lesions. Patients with RLS had significantly higher prevalence of pathological spinal cord lesions compared to patients without RLS (p=0.04). Sleep quality was found to be poor in both patients with cervical cord lesions and patients with RLS and this was statistically significant (p=0.031, p=0.0001). Conclusions: In summary, the possibility of RLS development in RRMS patients increases with the presence of lesions in spinal cord. Sleep quality was found to be poor in both patients with cervical cord lesions and patients with RLS. As RLS is a potentially treatable condition, increased awareness of diagnosis of RLS in MS patients may be important for early treatment and improve the comfort of the patient.

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