Association between restless legs syndrome and peripheral neuropathy: A systematic review and meta‐analysis

Background and purpose The coexistence of peripheral neuropathy (PN) and restless legs syndrome (RLS) or Willis–Ekbom disease is relatively frequent, but its prevalence has shown a high variability across studies. In addition, several reports have shown data suggesting the presence of PN in patients...

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Published in:European journal of neurology 2021-07, Vol.28 (7), p.2423-2442
Main Authors: Jiménez‐Jiménez, Félix Javier, Alonso‐Navarro, Hortensia, García‐Martín, Elena, Agúndez, José A.G.
Format: Article
Language:English
Subjects:
Amyloid
Biopsy
Charcot-Marie-Tooth disease
Coexistence
Confidence intervals
Diabetes mellitus
Heterogeneity
Leg
Meta-analysis
Peripheral neuropathy
Polyneuropathy
quantitative sensory tests
Restless legs syndrome
small sensory fibre loss
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Summary:Background and purpose The coexistence of peripheral neuropathy (PN) and restless legs syndrome (RLS) or Willis–Ekbom disease is relatively frequent, but its prevalence has shown a high variability across studies. In addition, several reports have shown data suggesting the presence of PN in patients with idiopathic RLS. Methods A search was undertaken using the PubMed, Embase and Web of Science Databases, from 1966 to 6 December 2020, crossing the search term ‘restless legs syndrome’ with ‘neuropathy’, ‘polyneuropathy’ (PNP) and ‘peripheral neuropathy’, and the references of interest for this topic were identified; a meta‐analysis was performed, according to PRISMA guidelines, and a calculation of pooled prevalences, where appropriate, was made using standard methods. Results Restless legs syndrome has been reported in 5.2%–53.7% of patients with PN (average 21.5%; 95% confidence interval 18.6%–24.5%), and PN has been reported in 0%–87.5% of patients with RLS (average 41.8%; 95% confidence interval 39.9%–43.6%), both being significantly more frequent than in controls. The heterogeneity across studies could be due to differences in the diagnostic criteria used for both RLS and PN. RLS is a frequent clinical complaint in patients with PN of different aetiologies, mainly diabetic PN, uraemic PNP, familial amyloid PNP, Charcot–Marie–Tooth disease and chronic dysimmune inflammatory PNP. Recent neurophysiological findings suggest the presence of small sensory fibre loss in patients diagnosed with idiopathic RLS, but it remains to be determined whether RLS associated with small sensory fibre loss and idiopathic RLS are different clinical entities. Conclusions Future studies including clinical and neurophysiological assessment and skin biopsy involving a large series of patients with PN and RLS are needed for a better understanding of the association between these two entities.
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.14840