Abstracts

Rationale: Objective: The aim of our study was to determine the prevalence of RLS in patients with epilepsy admitted either to the epilepsy monitoring unit (EMU) of our hospital or seen in the outpatient clinics and to further analyze its association with seizure type (generalized vs focal epilepsy), seizure control status (well controlled vs poorly controlled epilepsy) and antiepileptic drug (AED) therapy. Background: Restless leg syndrome (RLS) is a common neurological disorder characterized by an uncomfortable urge to move ones legs with associated dysesthesias that typically occur in the evening and at rest and are temporarily relieved by movement. This disorder may be primary (idiopathic) or secondary to other causes. Secondary RLS has been associated with renal disease, iron deficiency, rheumatoid arthritis, Parkinson's disease, pregnancy, neuropathies, radiculopathies, and myelopathies. While the prevalence of RLS in the general population is estimated to be between 2.5 to 29%, it is generally greater than 20%, and up to 40%, in patients with these associated conditions. Currently, it is unknown if there is an association between RLS and epilepsy, and more specifically with certain types of epilepsy, seizure control status, and antiepileptic drugs. Methods: Methods: We enrolled all epilepsy patients consecutively admitted to the adult EMU of New York Presbyterian Hospital/Weill Cornell Medical Center or seen in the outpatient clinics. Patients were admitted to the EMU either for characterization of their seizure disorder, assessment of seizure control, or for medication adjustment. Epilepsy patients are usually followed every 3-4 months in the outpatient clinic or as an office visit. Only patients who carried an established diagnosis of epilepsy and were on AED therapy were enrolled. Patients who were admitted for characterization of unusual spells and syncopal episodes were excluded. A patient was determined to have RLS if he or she met all the four International Restless Leg Syndrome (IRLS) criteria. The criteria were administered to the patient at the time of admission to the EMU or after their office visit by one of the three study authors. Patients who satisfied the IRLS criteria were further graded on the severity of their RLS and this was correlated to their seizure type, seizure control status and AED status. Results: Results: A total of seven (36.8%) subjects with epilepsy met the IRLS criteria (five or 45.5% of males and two or 22.2% of females) out of 19 subjects with epilepsy interviewed to date. Conclusions: Conclusion: Thus far, our study shows that 36.8% of patients with epilepsy had symptoms of RLS, which is significantly higher than the estimated 2.5 to 29% prevalence in the general population. In patients with epilepsy, RLS may be the consequence of involvement of thalamocortical and cortical-subcortical pathways as well as AED therapy. Further studies are needed to clarify the association of RLS in patients with epilepsy.