تعیین همراهی سندروم پاهای بیقرار با سردردهای اولیه در بیماران مراجعه کننده به بیمارستان 22 بهمن مشهد در سالهای 1391-1390
محورهای موضوعی : علوم پزشکیمحسن مهدی نژاد کاشانی 1 , فاطمه رحیمی 2
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کلید واژه: سردرد اولیه- سندرم پاهای بیقرار (RLS)- اختلال خواب,
چکیده مقاله :
مقدمه: مطالعات زیادی در رابطه با تداخل عمل بین سردردهای اولیه و سیستم اکستراپیرامیدال موجود است. هدف این مطالعه ارزیابی ارتباط بین سندرم پاهای بیقرار (RLS) و سردردهای اولیه در بیماران مراجعه کننده به کلینیک اعصاب می باشد. روش پژوهش: بیماران مراجعه کننده به کلینیک اعصاب بیمارستان 22 بهمن از نظر سردردهای اولیه بر اساس کرایتریای HIS مورد ارزیابی قرار گرفتند افراد با سایر اختلالات منجر به RLS از مطالعه حذف شدند. سپس بیماران با سردردهای اولیه از جهت ابتلا به RLS بر اساس معیارهای بین المللی مورد مصاحبه واقع شدند و در صورت ابتلاء شیوع آن در هفته و وضعیت اختلال خواب در آنها مورد بررسی قرار گرفت. سپس یکی از اعضای خانواده بیمار بدون سردرد از نظر ابتلا به RLS مورد مصاحبه واقع شد. اطلاعات با استفاده از نرم افزار آماری SPSS مورد تجزیه و تحلیل قرار گرفت. نتایج: در این مطالعه 100 بیمار مبتلا به سردردهای اولیه و 100 نفر بدون سردرد به عنوان گروه کنترل بررسی شدند. 67% از افراد گروه مورد و 64% از افراد گروه شاهد را خانم ها تشکیل می دادند. میانگین سنی گروه های مورد و شاهد به ترتیب 1/12± 4/35 و 3/12±35 سال بود. 68% مبتلا به سردرد میگرنی، 29% فشاری و 3% خوشه ای بودند. ارتباط معنی داری بین ابتلاء به سردردهای اولیه و RLS وجود داشت (32% در گروه مورد و 12% در گروه شاهد مبتلا به RLS بودند) در بیماران مبتلا به سردرد+ RLS اختلال خواب در 75% موارد مشاهده شد. 6/34% مردان مبتلا به سردرد RLS داشتند (008/0= P) و 9/29% از خانم های مبتلا به سردرد RLS داشتند (022/0= P). شیوع RLS در بیماران مبتلا به سردرد با افزایش سن افزایش می یافت (05/0 p<) نتیجه گیری: از آنجا که شیوع RLS در افراد مبتلا به سردرد به طور معنی داری بالاتر می باشد مطالعات بیشتری جهت یافتن مسیرهای پاتوژنیک مشابه بین این دو اختلال نیاز است.
Background and Objective: A large series of clinical and experimental observations on the interactions between migraine and the extrapyramidal system are available. The aim of this study was to evaluate assosiation between restless leg syndrome (RLS) and primary headache in patient referred to neurology clinic. Methods: patients referred to clinic of neurology of 22Bahman hospital were evaluated for primary headaches according to HIS cirteria. Then patients with other neurologic disorders which caysed to RLS were excluded. Patient with primary headache only were interviewed for RLS according to international criteria and if affected, its frequency in week and sleep disorders were evaluated. Then a family member of patient without headache was reviewedfor RLS. Data was reviewed for RLS. Data was statistically analyzed using SPSS software. Results: There were 100 patients with primary headaches and 100 without headache as control group evaluated. 67% of case group and 64% of control were women. Mean age of case and control groups were 35.4±12.1 and 35±12.3 years respectively. There were 68% migrain, 29% tension and 3% were cluster headaches. There was a significant relaton between primary headaches and RLS (32% in case group and 12% in control group were affected). In patients with headache pluse RLS, sleep disorder was seen in 75% . 34.6% of men with headache had RLS (p=0/008) and 29.9% of women with headache had RLS (P=0.022). Frequency of RLS in patients with headache increased as age increased (p<0.05). Conclusion: As RLS is significantly higher in headache patients more studies are needed in order to find same pathogenic ways.
1- Biary N, Koller W, Langenberg P. Correlation between essential tremor and migraine headache. J Neurol Neurosurg Psychiatry.1990; 53(11):1060–1062.
2- Kwak C, Vuong KD, Jankovic J. Migraine headache in patients with Tourette syndrome. Arch Neurol. 2003; 60(14):1595–1598.
3- Teixera AL Jr, Meira FC, Maia DP, et al. Migraine headache in patients with Sydenham’s chorea. Cephalalgia. 2004; 25(5):542–544.
4- Rains JC, Poceta JS. Headache and sleep disorders: review and clinical implications for headache management. Headache. 2006; 46(11):1344–1363.
5- Bigal ME, Lipton RB. Headache Classification. In: Bigal ME, Lipton RB. Migraine and other headache disorders. 1st ed.New York: Informa; 2006. P.1-21.
6- Michael J. Aminoff, David A, Roger P. Chronic headache clinical neurology. NewYork. Lange medical book S/MC Graw Hill; 2005.p. 85-91.
7- Evans RW, Mathew NT.Hand book of headache. 12th ed. Philadelphia :lipincotte Williams & Wilkins; 2001.p.350-339.
8- Davidoff RA. Migraine manifestations, pathogenesis, and management.2nd ed. New York: Oxford university press; 2002.p. 3-89.
9- Cheung RT, Prevalence of Migraine, Tension-type headache , and other headaches in Hong Kong. Headache. 2000 Jun; 40(6):p473-9.
10- Bradley WG, Daroff RB, Fenichel GM, Jankovic J, editors. Neurology in clinical practice. 5th edition. Philadelphia: Elsevier’s Health Sciences Rights Department. 2008;p:2011–62.
11- Low NC, Merikangas KR. Comorbidity of migraine. In: Bigal ME, Lipton RB. Migraine and other headache disorders. 1st ed. New York: Informa; 2006. P.45-60.
12. Ekbom KA. Restless legs. Acta Med Scand Suppl. 1945; 158(1):1-123.
13.Montplaisir J, Nicolas A, Godbout R, Walters A. Restless Legs Syndrome and Periodic Limb Movement Disorders. In: Kryger M, Roth T, Dement W. Principles and practice of Sleep Medicine. 3rd ed. Philadelphia: saunders company; 2000. 742-752.
14. Montplaisir J, Boucher S, Poirier G, et al. Clinical poly somnographic and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Mov Disord. 1996; 12:61-65.
15. Trenkwalder C, Walters AS, Hening W. Periodic limb movements and restless legs syndrome. Neural Clin. 1996; 14:629-649.
16. Coleman RM, Bliwise DL, Sajben N, et al. Epidemiology of peridic movements during sleep. In: Guilleminault C, Lugaresi E, eds. Sleep/ Wake Disorders. Natural History, Epidemiology and Long Term Evolution. New York, NY: Raven Press; 1988: 217-229.
17. The International Restless Legs Syndrome Study Group. Towards a better definition of the restless legs syndrome from the international restless legs syndrome study group. Mov Disord. 1995; 10:634-642.
18. Ondo W, Jankovic J. Restles legs syndrome: clinicoetiologic correlates. Neurology. 1996; 47: 1435-1441.
19. Rutkove SB, Matheson JK, Logigian EL. Restless legs syndrome in patients with polyneuropathy. Muscle Nerve. 1996, 19:670-672.
20. Matthew WB. Iron deficiency and restless legs. Br Med J. 1976; 1:898.
21. Yunus MB, Aldag JC. Restless legs syndrome and leg cramps in fibromyalgia syndrome: a controlled study. Br Med J. 1996; 312: 1339.
22. Reynolds G, Black DR, Pall HS, et al. Restless legs syndrome and rheumatoid arthritis. Br Med J. 1986; 292: 659-660.
23. d’Onofrio, D. Cologno, V. Petretta, et al. Restless legs syndrome is not associated with migraine with aura: a clinical study. Neurol Sci 2011; 32: 153–156.
24. Chen PK, Fuh JL, Chen SP, Wang SJ. Association between restless legs syndrome and migraine.J Neurol Neurosurg Psychiatry 2010; 81(5):524-8.
25.Florindo d’Onofrio, Gennaro Bussone, Daniela Cologno, et al. Restless legs syndrome and primary headaches: a clinical study. Neurol Sci 2008; 29: 169–172.
26. Fernández-Matarrubia M1, Cuadrado ML, Sánchez-Barros CM, Martínez-Orozco FJ, Fernández-Pérez C, Villalibre I, Ramírez-Nicolás B,Porta-Etessam J. Prevalence of Migraine in Patients With Restless Legs Syndrome: A Case-Control Study. Headache. 2014 May 20;43(5):567-573.
27. Zanigni S1, Giannini G, Melotti R, Pattaro C, Provini F, Cevoli S, Facheris MF, Cortelli P, Pramstaller PP. Association between restless legs syndrome and migraine: a population-based study. Eur J Neurol. 2014 May 20;15(3):326-332.
28. Gozubatik-Celik G1, Benbir G, Tan F, Karadeniz D, Goksan B. The prevalence of migraine in restless legs syndrome. Headache. 2014 May; 54(5):872-7.
29. Seidel S1, Böck A, Schlegel W, Kilic A, Wagner G, Gelbmann G, Hübenthal A, Kanbur I, Natriashvili S, Karwautz A, Wöber C, Wöber-Bingöl C. Increased RLS prevalence in children and adolescents with migraine: a case-control study. Cephalalgia. 2012 Jul;32(9):693-9.
30. Gupta R1, Lahan V, Goel D. Primary headaches in restless legs syndrome patients. Ann Indian Acad Neurol. 2012 Aug;15(Suppl 1):S104-8.
31. Florindo D1, Daniela C, Giulio C, Vittorio P, Gabriella M, Vincenzo T, Eliana M, Gerardo C, Gennaro B. Cluster headache patients are not affected by restless legs syndrome: an observational study. Clin Neurol Neurosurg. 2012 May;113(4):308-10.
32. Rhode AM1, Hösing VG, Happe S, Biehl K, Young P, Evers S. Comorbidity of migraine and restless legs syndrome--a case-control study. Cephalalgia. 2009 Nov;27(11):1255-60.
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