Multipl Skleroz Hastalarında Huzursuz Bacaklar Sendromu

Özet

Amaç: Multipl Skleroz (MS) ile Huzursuz bacaklar sendromu/WillisEKbom Hastalığı (HBS) birlikteliği sık görülmektedir, çalışmamızdaHBS’nin MS hastalarının üzerindeki etkisini ve bu iki durumun birbiri ileolan ilişkisini anlamayı amaçladık.Yöntem: Bu kesitsel çalışmada 2010–2015 tarihleri arasında kliniğimizdekesin MS tanısı ile takip edilen (2010 Mc Donald kriterlerine göre) 102hasta dahil edildi. Tüm hastalar HBS tanısı için 2012 revize IRLSSGtanı ölçeğine göre değerlendirildi. Tüm hastaların EDSS puanları, BeckDepresyon Ölçeği puanları, Beck Anksiyete Ölçek puanları, YorgunlukŞiddet Skalası puanları kayıt edildi. HBS şiddetini belirlemek için IRLSSG2003 Şiddet Skalası kullanıldı.Bulgular: Çalışmaya katılan MS hastalarının %30,4’ünde HBS kriterlerinidolduran şikayetler mevcut iken (MS/HBS+), %69,6’unda (n=71) ise HBSşikayeti mevcut değildi (MS/HBS-). MS/HBS+ hastaların ortalama EDSSskorları 3,2±2,1 iken MS/HBS- olan hastalarda 2,0±1,6 idi. Depresyonvarlığı, orta veya ağır derecede anksiyete varlığı, bitkinlik ve barsakmesanedisfonksiyonu MS/HBS+ hastalarında istatistiksel olarak anlamlıoranda daha yüksek saptandı. MS/HBS+ grubunda HBS şikayetlerinin%32,2’si çok hafif, %35,4’ü orta, %19,3’u ağır ve %12,9’u çok ağır idi.Hastalar MS alt grupları açısından incelendiğinde en yüksek HBS şiddetiSP MS alt grubunda saptandı. Ayrıca piramidal semptomların, depresifşikayetleri olan veya anksiyete saptanmış olan hastalarda veya barsakmesanedisfonksiyonu varlığında ortalama HBS şiddeti istatistiksel olarakanlamlı derecede artmakta idi. HBS şiddeti piramidal atak sayısı ile veEDSS skoru ile de yakında ilişkili idi.Sonuç: HBS, MS hastalarında depresyon, anksiyete, bitkinlik yaratansebeplerden birisidir ve hastaların kliniğinde kötü bir etkiye sahiptir. Bunedenle klinisyenler tarafından fark edilmesi ve erken dönemde tedaviedilmesi MS hastaların hayat kalitesi ve tedavi uyumu için önemli olabilir.

Abstract

Introduction: The co-existence of Restless Legs Syndrome (RLS) and Multiple Sclerosis (MS) is a common condition. For this reason, we aimed to evaluate the effects of RLS and its relationship with MS. Methods: We evaluated the clinical features of 102 patients diagnosed with MS who were in follow-up between 2010 and 2015 in outpatient clinic. All the patients were evaluated for RLS according to the revised International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria. The Expanded Disability Status Scale (EDSS), Beck Depression Inventory, Beck Anxiety Inventory and Fatigue Severity Scale scores of all the patients were recorded. The IRLSSG 2003 severity scale was used to determine the degree of RLS. Results: RLS was detected in 30.4% (n=31) of the patients (MS/RLS+), but not in 69.6% (n=71) (MS/RLS-). The mean EDSS score of the MS/ RLS+ patients were 3.2±2.1 while the MS/RLS-patients were 2.0±1.6. The incidences of depression, moderate or severe anxiety, fatigue and intestinal and bladder dysfunction in the MS-RLS+ patients were significantly higher. Regarding to RLS complaints, 32.2% were mild, 35.4% were moderate, 19.3% were severe and 12.9% were very severe. When the MS subgroups were evaluated the highest RLS severity score was found in the secondary progressive MS group. In the patients with pyramidal symptoms and intestinal and bladder dysfunction, the mean RLS severity was significantly higher. The mean RLS severity score was also significantly higher in those with depression and anxiety. The RLS severity was significantly correlated with the number of pyramidal attacks and the EDSS score. Conclusion: Restless legs syndrome is a cause of depression, anxiety and fatigue and has negative effects on MS patients. Therefore, after the diagnosis of MS, the RLS symptoms and signs should be determined, as soon as possible, in addition to the other MS symptoms. The treatment of this condition should be started early.