内包後脚梗塞後にrestless shoulderを認めた70歳女性

症例は70歳女性．起床時より呂律緩慢と左上下肢の脱力が出現した．神経学的所見にて構音障害と左不全片麻痺を認めたが，感覚障害はなかった．頭部MRIにて右内包後脚に新規梗塞巣を認めた．発症第1日目より両肩に限局した異常感覚が出現し，それに伴う入眠困難が出現した．血液検査では腎機能は正常であり，血清ヘモグロビンおよびフェリチン値も正常であった．レストレスレッグス症候群（restless legs syndrome; RLS）の診断基準を患者の両肩に適用すると主要4項目を満たした．低用量プラミペキソール開始後両肩の異常感覚，不眠症状は改善した．急性期脳梗塞後の不眠の原因としてRLSやその亜型の可能性を...

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Published in臨床神経学 Vol. 57; no. 11; pp. 711 - 715
Main Authors 岡村, 穏, 椎名, 智彦, 中村, 利生, 平田, 幸一, 鈴木, 圭輔, 宮本, 雅之, 松原, 健朗
Format Journal Article
LanguageJapanese
Published 日本神経学会 2017
Subjects
restless shoulder
レストレスレッグス症候群
内包後脚梗塞
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ISSN0009-918X
1882-0654
DOI10.5692/clinicalneurol.cn-001048

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Abstract 症例は70歳女性．起床時より呂律緩慢と左上下肢の脱力が出現した．神経学的所見にて構音障害と左不全片麻痺を認めたが，感覚障害はなかった．頭部MRIにて右内包後脚に新規梗塞巣を認めた．発症第1日目より両肩に限局した異常感覚が出現し，それに伴う入眠困難が出現した．血液検査では腎機能は正常であり，血清ヘモグロビンおよびフェリチン値も正常であった．レストレスレッグス症候群（restless legs syndrome; RLS）の診断基準を患者の両肩に適用すると主要4項目を満たした．低用量プラミペキソール開始後両肩の異常感覚，不眠症状は改善した．急性期脳梗塞後の不眠の原因としてRLSやその亜型の可能性を念頭に置く必要がある．
AbstractList 症例は70歳女性．起床時より呂律緩慢と左上下肢の脱力が出現した．神経学的所見にて構音障害と左不全片麻痺を認めたが，感覚障害はなかった．頭部MRIにて右内包後脚に新規梗塞巣を認めた．発症第1日目より両肩に限局した異常感覚が出現し，それに伴う入眠困難が出現した．血液検査では腎機能は正常であり，血清ヘモグロビンおよびフェリチン値も正常であった．レストレスレッグス症候群（restless legs syndrome; RLS）の診断基準を患者の両肩に適用すると主要4項目を満たした．低用量プラミペキソール開始後両肩の異常感覚，不眠症状は改善した．急性期脳梗塞後の不眠の原因としてRLSやその亜型の可能性を念頭に置く必要がある．
Author 鈴木, 圭輔
平田, 幸一
椎名, 智彦
宮本, 雅之
岡村, 穏
中村, 利生
松原, 健朗
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  fullname: 松原, 健朗
  organization: 獨協医科大学神経内科
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References 10) Aquino CC, Mestre T, Lang AE. Restless genital syndrome in Parkinson disease. JAMA Neurol 2014;71:1559-1561.
12) Suzuki K, Miyamoto M, Uchiyama T, et al. Restless bladder in an elderly woman: an unusual feature or a variant of restless legs syndrome? Intern Med 2016;55:2713-2716.
6) Khan FH, Ahlberg CD, Chow CA, et al. Iron, dopamine, genetics, and hormones in the pathophysiology of restless legs syndrome. J Neurol 2017;264:1634-1641.
16) 澤村正典，當間圭一郎，垂髪祐樹ら．陰部むずむず感で発症したパーキンソン病の1例．臨床神経 2015;55:266-268.
7) St Louis EK, Ulfberg J. Putting the legs back into restless legs syndrome: new evidence for the microvascular hypothesis. Neurology 2014;82:1850-1851.
11) Suzuki K, Miyamoto M, Miyamoto T, et al. Restless “lower back” in a patient with Parkinson’s disease. Tremor Other Hyperkinet Mov (N Y) 2013;3:tre-03-195-4313-2.
14) Umehara H, Sumitani S, Ohmori T. Restless legs syndrome with chest and back restlessness as the initial symptom. Psychiatry Clin Neurosci 2010;64:211.
15) Wylie K, Levin R, Hallam-Jones R, et al. Sleep exacerbation of persistent sexual arousal syndrome in a postmenopausal woman. J Sex Med 2006;3:296-302.
1) Allen RP, Picchietti D, Hening WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003;4:101-119.
17) Woo HG, Lee D, Hwang KJ, et al. Post-stroke restless leg syndrome and periodic limb movements in sleep. Acta Neurol Scand 2017;135:204-210.
9) Antelmi E, Coccagna G, Ferini-Strambi L, et al. ‘Restless bladder’ and the boundaries of the restless legs syndrome. Eur J Neurol 2013;20:e128.
3) Perez-Diaz H, Iranzo A, Rye DB, et al. Restless abdomen: a phenotypic variant of restless legs syndrome. Neurology 2011;77:1283-1286.
8) Ando T, Goto Y, Mano K. Upper back restlessness: Two case reports. J Neurol Sci 2016;365:137-138.
18) Gupta A, Shukla G, Mohammed A, et al. Restless legs syndrome, a predictor of subcortical stroke: a prospective study in 346 stroke patients. Sleep Med 2017;29:61-67.
19) Ferri R, Cosentino FI, Moussouttas M, et al. Silent cerebral small vessel disease in restless legs syndrome. Sleep 2016;39:1371-1377.
13) Suzuki M, Yamada K, Kanamori T, et al. Abdominal paresthesia resembling restless legs syndrome successfully treated with iron supplement therapy: a case report. J Neurol Sci 2014;336:291-292.
5) Clemens S, Rye D, Hochman S. Restless legs syndrome: revisiting the dopamine hypothesis from the spinal cord perspective. Neurology 2006;67:125-130.
4) Lee SJ, Kim JS, Song IU, et al. Poststroke restless legs syndrome and lesion location: anatomical considerations. Mov Disord 2009;24:77-84.
2) Horvath J, Landis T, Burkhard PR. Restless arms. Lancet 2008;371:530.
References_xml – reference: 8) Ando T, Goto Y, Mano K. Upper back restlessness: Two case reports. J Neurol Sci 2016;365:137-138.
– reference: 9) Antelmi E, Coccagna G, Ferini-Strambi L, et al. ‘Restless bladder’ and the boundaries of the restless legs syndrome. Eur J Neurol 2013;20:e128.
– reference: 16) 澤村正典，當間圭一郎，垂髪祐樹ら．陰部むずむず感で発症したパーキンソン病の1例．臨床神経 2015;55:266-268.
– reference: 17) Woo HG, Lee D, Hwang KJ, et al. Post-stroke restless leg syndrome and periodic limb movements in sleep. Acta Neurol Scand 2017;135:204-210.
– reference: 14) Umehara H, Sumitani S, Ohmori T. Restless legs syndrome with chest and back restlessness as the initial symptom. Psychiatry Clin Neurosci 2010;64:211.
– reference: 18) Gupta A, Shukla G, Mohammed A, et al. Restless legs syndrome, a predictor of subcortical stroke: a prospective study in 346 stroke patients. Sleep Med 2017;29:61-67.
– reference: 6) Khan FH, Ahlberg CD, Chow CA, et al. Iron, dopamine, genetics, and hormones in the pathophysiology of restless legs syndrome. J Neurol 2017;264:1634-1641.
– reference: 11) Suzuki K, Miyamoto M, Miyamoto T, et al. Restless “lower back” in a patient with Parkinson’s disease. Tremor Other Hyperkinet Mov (N Y) 2013;3:tre-03-195-4313-2.
– reference: 15) Wylie K, Levin R, Hallam-Jones R, et al. Sleep exacerbation of persistent sexual arousal syndrome in a postmenopausal woman. J Sex Med 2006;3:296-302.
– reference: 2) Horvath J, Landis T, Burkhard PR. Restless arms. Lancet 2008;371:530.
– reference: 3) Perez-Diaz H, Iranzo A, Rye DB, et al. Restless abdomen: a phenotypic variant of restless legs syndrome. Neurology 2011;77:1283-1286.
– reference: 19) Ferri R, Cosentino FI, Moussouttas M, et al. Silent cerebral small vessel disease in restless legs syndrome. Sleep 2016;39:1371-1377.
– reference: 7) St Louis EK, Ulfberg J. Putting the legs back into restless legs syndrome: new evidence for the microvascular hypothesis. Neurology 2014;82:1850-1851.
– reference: 4) Lee SJ, Kim JS, Song IU, et al. Poststroke restless legs syndrome and lesion location: anatomical considerations. Mov Disord 2009;24:77-84.
– reference: 13) Suzuki M, Yamada K, Kanamori T, et al. Abdominal paresthesia resembling restless legs syndrome successfully treated with iron supplement therapy: a case report. J Neurol Sci 2014;336:291-292.
– reference: 5) Clemens S, Rye D, Hochman S. Restless legs syndrome: revisiting the dopamine hypothesis from the spinal cord perspective. Neurology 2006;67:125-130.
– reference: 10) Aquino CC, Mestre T, Lang AE. Restless genital syndrome in Parkinson disease. JAMA Neurol 2014;71:1559-1561.
– reference: 12) Suzuki K, Miyamoto M, Uchiyama T, et al. Restless bladder in an elderly woman: an unusual feature or a variant of restless legs syndrome? Intern Med 2016;55:2713-2716.
– reference: 1) Allen RP, Picchietti D, Hening WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003;4:101-119.
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SubjectTerms restless shoulder
レストレスレッグス症候群
内包後脚梗塞
Title 内包後脚梗塞後にrestless shoulderを認めた70歳女性
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