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Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) in the child psychiatry clinic: an occult and hidden comorbidity Ahmed Elaghoury*, MD, Manal Abed, MD, Khaled Shehatto, MD Abbassia Hospital for Mental Health, Cairo, Egypt Pediatric Restless Legs Syndrome/Willis- Ekbom Disease, (RLS/WED) (17) ADHD Developmental /Intellectual disabilities (11) Tic disorders Growing pains (19,21) Medication induced RLS, esp with psychotropics. (8) Autism spectrum disorders (11) Migraine (3) History of prematurity (preterm) (7) Depression (3) URGE Mnemonic (4) U: Urge or sensation to move the legs R: Rest or stillness of the legs worsens the urge to move G: Going / Ground is good (at least temporary relief of the urge occurs with movement) E: Evening or nighttime worsening of symptoms Consider RLS/WED during mental healthcare of any of these clinical situations, when dealing with sleep difficulty in a child RLS has a phenotypic series: PS102300, (OMIM) REFERENCES: 1. Allen RP et al. Ch 95: Restless Legs Syndrome and Periodic Limb Movements During Sleep. In: Kryger, M. H., Roth, T., & Dement, W. C. (2017). Principles and practice of sleep medicine. 6th ed. Elsevier 2. American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed. Darien, IL. American Academy of Sleep Medicine, 2014. 3. Angriman M, Cortese S, Bruni O. Somatic and neuropsychiatric comorbidities in pediatric restless legs syndrome: A systematic review of the literature. Sleep Med Rev. 2017 Aug;34:34-45. doi: 10.1016/j.smrv.2016.06.008. Epub 2016 Jul 1. Review. PubMed PMID: 27519964. 4. Philip M. Becker: Restless Legs Syndrome. In: Sleep: A Comprehensive Handbook, Edited by T. Lee-Chiong. 2006 John Wiley & Sons, Inc. 5. Bruni, O., & Angriman, M. (2017). Management of RLS in Children (Unique Features). In Restless Legs Syndrome/Willis Ekbom Disease (pp. 261-278). Springer New York. 6. Chokroverty, S. (2015). Differential Diagnoses of Restless Legs Syndrome/Willis-Ekbom Disease. Sleep medicine clinics, 10(3), 249-262. 7. Cielo, C. M., DelRosso, L. M., Tapia, I. E., Biggs, S. N., Nixon, G. M., Meltzer, L. J., ... & Marcus, C. L. (2017). Periodic limb movements and restless legs syndrome in children with a history of prematurity. Sleep Medicine, 30, 77-81. 8. Drug-induced restless legs syndrome. Prescrire Int. 2010 Aug;19(108):164-5. PubMed PMID: 20939448. 9. Furudate, N., Komada, Y., Kobayashi, M., Nakajima, S., & Inoue, Y. (2014). Daytime dysfunction in children with restless legs syndrome. Journal of the neurological sciences, 336(1), 232-236. 10. Hamilton-Stubbs, P. E., & Walters, A. S. (2017). Sleep Disorders in Children: Simple Sleep-Related Movement Disorders. In Sleep Disorders in Children (pp. 227-251). Springer International Publishing. 11. Ipsiroglu, O. S., Beyzaei, N., Berger, M., Wagner, A. L., Dhalla, S., Garden, J., & Stockler, S. (2016). “Emplotted Narratives” and Structured “Behavioral Observations” Supporting the Diagnosis of Willis‐Ekbom Disease/Restless Legs Syndrome in Children with Neurodevelopmental Conditions. CNS neuroscience & therapeutics, 22(11), 894- 905. 12. Lane, R., Kessler, R., Buckley, A. W., Rodriguez, A., Farmer, C., Thurm, A., ... & Felt, B. (2015). Evaluation of periodic limb movements in sleep and iron status in children with autism. Pediatric neurology, 53(4), 343-349. 13. Mahmoudi, M., & Kothare, S. V. (2017). Restless Legs Syndrome. In Sleep Disorders in Adolescents (pp. 27-44). Springer International Publishing. 14. Makker, H., Walker, M., Selsick, H., Kotecha, B., & Johal, A. (2015). Oxford Case Histories in Sleep Medicine. OUP Oxford. 15. Malhotra R. Ch 12: Restless Legs Syndrome, Periodic Limb Movements, and Other Movement Disorders in Sleep. In: Kirsch, D. (Ed.). (2014). Sleep Medicine in Neurology. John Wiley & Sons. 16. Oldham, M. A., & Lee, H. B. (2017). Mental Health Disorders Associated with RLS. In Restless Legs Syndrome/Willis Ekbom Disease (pp. 21-43). Springer New York. 17. Picchietti, D. L., Bruni, O., de Weerd, A., Durmer, J. S., Kotagal, S., Owens, J. A., ... & International Restless Legs Syndrome Study Group. (2013). Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group. Sleep medicine, 14(12), 1253-1259. 18. Pullen, S. J., Wall, C. A., Angstman, E. R., Munitz, G. E., & Kotagal, S. (2011). Psychiatric comorbidity in children and adolescents with restless legs syndrome: a retrospective study. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 7(6), 587. 19. Simakajornboon, N., Dye, T. J., & Walters, A. S. (2015). Restless legs syndrome/Willis-Ekbom disease and growing pains in children and adolescents. Sleep medicine clinics, 10(3), 311-322. 20. Szuhay G. Question 24. In: Chidekel AS, ed. (2016) Curbside Consultation in Pediatric Sleep Disorders: 49 Clinical Questions (pp. 111-114). SLACK Incorporated 21. Walters, A. S., Gabelia, D., & Frauscher, B. (2013). Restless legs syndrome (Willis–Ekbom disease) and growing pains: are they the same thing? A side-by-side comparison of the diagnostic criteria for both and recommendations for future research. Sleep medicine, 14(12), 1247-1252. Email: [email protected]

Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) in the child psychiatry clinic: an occult and hidden comorbidity

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Page 1: Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) in the child psychiatry clinic: an occult and hidden comorbidity

Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) in the child psychiatry clinic: an occult and hidden comorbidity

Ahmed Elaghoury*, MD, Manal Abed, MD, Khaled Shehatto, MDAbbassia Hospital for Mental Health, Cairo, Egypt

Pediatric Restless Legs Syndrome/Willis-Ekbom Disease, (RLS/WED) (17)

ADHD

Developmental /Intellectual

disabilities (11)

Tic disorders

Growing pains (19,21)Medication induced

RLS, esp with psychotropics. (8)

Autism spectrum

disorders (11)

Migraine (3)

History of prematurity (preterm) (7)

Depression (3)

URGE Mnemonic (4)

U: Urge or sensation to move the legs

R: Rest or stillness of the legs worsens the urge to move

G: Going / Ground is good (at least temporary relief of the urge occurs with movement)

E: Evening or nighttime worsening of symptoms

Consider RLS/WED during mental healthcare of any of these clinical situations, when dealing with sleep difficulty in a child

RLS has a phenotypic series: PS102300, (OMIM)

REFERENCES:1. Allen RP et al. Ch 95: Restless Legs Syndrome and Periodic Limb Movements During Sleep. In: Kryger, M. H., Roth,

T., & Dement, W. C. (2017). Principles and practice of sleep medicine. 6th ed. Elsevier2. American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed. Darien, IL. American

Academy of Sleep Medicine, 2014.3. Angriman M, Cortese S, Bruni O. Somatic and neuropsychiatric comorbidities in pediatric restless legs syndrome: A

systematic review of the literature. Sleep Med Rev. 2017 Aug;34:34-45. doi: 10.1016/j.smrv.2016.06.008. Epub2016 Jul 1. Review. PubMed PMID: 27519964.

4. Philip M. Becker: Restless Legs Syndrome. In: Sleep: A Comprehensive Handbook, Edited by T. Lee-Chiong. 2006John Wiley & Sons, Inc.

5. Bruni, O., & Angriman, M. (2017). Management of RLS in Children (Unique Features). In Restless LegsSyndrome/Willis Ekbom Disease (pp. 261-278). Springer New York.

6. Chokroverty, S. (2015). Differential Diagnoses of Restless Legs Syndrome/Willis-Ekbom Disease. Sleep medicineclinics, 10(3), 249-262.

7. Cielo, C. M., DelRosso, L. M., Tapia, I. E., Biggs, S. N., Nixon, G. M., Meltzer, L. J., ... & Marcus, C. L. (2017). Periodiclimb movements and restless legs syndrome in children with a history of prematurity. Sleep Medicine, 30, 77-81.

8. Drug-induced restless legs syndrome. Prescrire Int. 2010 Aug;19(108):164-5. PubMed PMID: 20939448.9. Furudate, N., Komada, Y., Kobayashi, M., Nakajima, S., & Inoue, Y. (2014). Daytime dysfunction in children with

restless legs syndrome. Journal of the neurological sciences, 336(1), 232-236.10. Hamilton-Stubbs, P. E., & Walters, A. S. (2017). Sleep Disorders in Children: Simple Sleep-Related Movement

Disorders. In Sleep Disorders in Children (pp. 227-251). Springer International Publishing.11. Ipsiroglu, O. S., Beyzaei, N., Berger, M., Wagner, A. L., Dhalla, S., Garden, J., & Stockler, S. (2016). “Emplotted

Narratives” and Structured “Behavioral Observations” Supporting the Diagnosis of Willis‐Ekbom Disease/RestlessLegs Syndrome in Children with Neurodevelopmental Conditions. CNS neuroscience & therapeutics, 22(11), 894-905.

12. Lane, R., Kessler, R., Buckley, A. W., Rodriguez, A., Farmer, C., Thurm, A., ... & Felt, B. (2015). Evaluation of periodiclimb movements in sleep and iron status in children with autism. Pediatric neurology, 53(4), 343-349.

13. Mahmoudi, M., & Kothare, S. V. (2017). Restless Legs Syndrome. In Sleep Disorders in Adolescents (pp. 27-44).Springer International Publishing.

14. Makker, H., Walker, M., Selsick, H., Kotecha, B., & Johal, A. (2015). Oxford Case Histories in Sleep Medicine. OUPOxford.

15. Malhotra R. Ch 12: Restless Legs Syndrome, Periodic Limb Movements, and Other Movement Disorders in Sleep. In:Kirsch, D. (Ed.). (2014). Sleep Medicine in Neurology. John Wiley & Sons.

16. Oldham, M. A., & Lee, H. B. (2017). Mental Health Disorders Associated with RLS. In Restless Legs Syndrome/WillisEkbom Disease (pp. 21-43). Springer New York.

17. Picchietti, D. L., Bruni, O., de Weerd, A., Durmer, J. S., Kotagal, S., Owens, J. A., ... & International Restless LegsSyndrome Study Group. (2013). Pediatric restless legs syndrome diagnostic criteria: an update by the InternationalRestless Legs Syndrome Study Group. Sleep medicine, 14(12), 1253-1259.

18. Pullen, S. J., Wall, C. A., Angstman, E. R., Munitz, G. E., & Kotagal, S. (2011). Psychiatric comorbidity in children andadolescents with restless legs syndrome: a retrospective study. Journal of clinical sleep medicine: JCSM: officialpublication of the American Academy of Sleep Medicine, 7(6), 587.

19. Simakajornboon, N., Dye, T. J., & Walters, A. S. (2015). Restless legs syndrome/Willis-Ekbom disease and growingpains in children and adolescents. Sleep medicine clinics, 10(3), 311-322.

20. Szuhay G. Question 24. In: Chidekel AS, ed. (2016) Curbside Consultation in Pediatric Sleep Disorders: 49 ClinicalQuestions (pp. 111-114). SLACK Incorporated

21. Walters, A. S., Gabelia, D., & Frauscher, B. (2013). Restless legs syndrome (Willis–Ekbom disease) and growingpains: are they the same thing? A side-by-side comparison of the diagnostic criteria for both and recommendationsfor future research. Sleep medicine, 14(12), 1247-1252.

Email: [email protected]