Poststroke Restless Legs Syndrome and Lesion location: Anatomical Considerations

Several case studies have reported on restless legs syndrome (RLS) associated with stroke. In this study, we investigated the prevalence and the lesion topography of post-stroke RLS. There were 137 patients with ischemic stroke included in this study. The diagnosis of RLS was made I month after the index stroke using the criteria established by the International RLS Study Group. All patients enrolled underwent magnetic resonance imaging within 7 days of the onset of the stroke, The prevalence of stroke-related RLS wits calculated, and the topography of the associated ischemic lesions was analyzed. Among 137 patients, 17 patients (12.4%) were diagnosed with RLS after a stroke. Stroke-related RLS Wits found in 10 Out of 33 patients with a basal ganglia/corona radiata infarct (30.3%), 1 out of 8 patients with an internal Capsular infarct (12.5%), and 1 out of 7 patients with a thalamic infarct (14.3%). 1, addition, one out of 54 with a cortical lesion with/without subcortical involvement (1.9%), and 4 out of 18 patients with it pontine lesion (22.2%) had RLS. The analysis of the lesions in the cortical and subcortical group Showed only 1 patient in the cortical group had stroke-related RLS, whereas 16 in the subcortical group had stroke-related RLS. The results of this study suggest that lesions of the subcortical brain areas such as the pyramidal tract and the basal ganglia-brainstem axis, which are involved in motor functions and sleep-wake cycles, may lead to RLS symptoms in patients after an ischemic stroke. (c) 2008 Movement Disorder Society