Somatotopic mapping of sensory symptom distribution in RLS

Abstract

Objectives: Restless legs syndrome (RLS) is a sensorimotor neurological disorder, in which the primary symptom is a compelling urge to move the legs, accompanied by unpleasant and disturbing sensations in the legs. Although the sensory symptoms of RLS are occurring mainly on the lower extremities, the distribution of sensory symptoms has not been reported in detail. Furthermore, sensory symptom distribution has tended to change in relation to severity, frequency and circadian variation. We investigated somatotopic distribution of sensory symptoms in patients with RLS.

Methods: Eighty patients with RLS were enrolled in this study. Sensory symptoms of RLS were evaluated by a single research nurse. Sensory distribution in each patient was depicted on the standard somatotopic template. Each somatotopic area has 3 values in terms of severity, frequency and timing of the day. After summing up of each value from all the patients, somatotopic maps using average value of patient group were made according to the various combinations of three variables.

Results: Mean age is 52.3±14.3 years old and 65% of patients was woman. Most patients are complaint of bilateral symptoms. In terms of severity, lower legs, particularly calf area, followed by anterior aspect of thigh are the most severe. Lower legs and thighs were the most frequent site in which patients were suffered from RLS sensory symptoms. Patients were complaint of sensory symptoms in posterolateral calf, lateral thigh, buttocks, and dorsum of foot and hand in the evening. Posterior calf, posterior thigh, plantar and dorsal surface of foot were the most frequent site for RLS symptoms during sleep. There is no significant difference of symptoms distribution between men and women.

Conclusions: We showed characteristic somatotopic distribution of RLS sensory symptoms. Common pattern of symptom distribution can be made based on diverse clinical variables such as ethnicity, gender, age and so on.