Restless legs syndrome due to brainstem stroke: A systematic review

Acta Neurol Scand. 2022 Nov;146(5):440-447. doi: 10.1111/ane.13702. Epub 2022 Sep 5.

Abstract

Restless Legs Syndrome (RLS) is a sleep-related movement disorder, which can also result from brainstem pathology. A systematic review of articles published in the electronic databases PubMed and Web of Science was conducted to summarize the existent literature on RLS associated with a brainstem stroke. We identified eight articles including 19 subjects with RLS due to brainstem ischemic lesion. The symptoms occurred simultaneously with the infarction (66.7%) or few days after (33.3%). The most common location of infarction was pons and less commonly medulla. In most cases (68.4%), symptoms were unilateral. In the majority of those cases (92.3%), the contralateral limb was affected due to a lateral pons infarction. RLS symptoms after infarction improved or resolved in almost 90% of cases within a few days up to 3 months. In almost all patients who received dopaminergic treatment (11 out of 13, 91.7%), the symptoms improved significantly or resolved completely. Screening for RLS has to be considered in patients suffering a brainstem stroke, particularly anteromedial pontine infarction. The appearance of acute unilateral RLS symptoms, usually in association with other sensorimotor deficits, should prompt the clinician to consider a vascular event in the brainstem. RLS in these cases seem to have a favorable outcome and respond well to dopaminergic treatment.

Keywords: brainstem; infarction; restless legs syndrome; stroke.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Brain Stem Infarctions* / complications
  • Brain Stem Infarctions* / diagnostic imaging
  • Brain Stem Infarctions* / pathology
  • Dopamine
  • Humans
  • Pons
  • Restless Legs Syndrome* / drug therapy
  • Restless Legs Syndrome* / etiology
  • Stroke* / complications
  • Stroke* / pathology

Substances

  • Dopamine