Periodic limb movement disorder
Introduction
Introduction to periodic limb movement disorders Periodic limb dyskinesia refers to a repetitive and striking physical activity during sleep. The patient is often unaware of the movement of the limb and its damage to sleep, which is often sufficient to interfere with sleep in the same bed. The lower limbs are at rest during the interictal period. Patients usually complain of difficulty falling asleep, having many wake-ups at night, and excessive sleepiness during the day. Some serious patients may also have limb movements when they are awakened. The patient's complaint may be affected by the frequency and arousal of the onset of exercise. The cause of the disease is still unclear. May be caused by lesions or autonomic dysfunction in the central nervous system of the brain. It has a common pathophysiological basis with restless legs syndrome. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: non-infectious Complications: sleep apnea syndrome
Cause
Causes of periodic limb dyskinesia
Primary factor (30%):
Patients with primary restless leg syndrome are often accompanied by a family history. It is currently believed that genes such as BTBD9, Meis1, MAP2K5, and LBXCOR1 may be associated with restless leg syndrome.
Secondary factors (30%):
Patients with secondary restless leg syndrome can be seen in iron deficiency anemia, maternal or maternal, late kidney disease, rheumatic diseases, diabetes, Parkinson's disease, type II hereditary motor neuropathy, type I/II spinal cord cerebellar Disorders and multiple sclerosis.
Other factors (30%):
The cause of the disease is still unclear. May be caused by lesions or autonomic dysfunction in the central nervous system of the brain. It has a common pathophysiological basis with restless legs syndrome. It is currently believed that restless leg syndrome belongs to the central nervous system disease, and the specific cause has not been fully elucidated.
Prevention
Periodic limb movement disorder prevention
Usually exercise more, strengthen exercise, improve physical fitness.
Complication
Periodic limb dyskinesia complications Complications sleep apnea syndrome
Can cause sleep apnea syndrome.
Symptom
Symptoms of periodic limb dyskinesia Common symptoms Motor dysfunction Intermittent muscle contraction Limb electric shock sense Sleep-wake time... Sudden convulsions while sleeping Sleep numbness After sleep, energy does not restore toe flexion contracture Skin type limb flexion
It is characterized by periodic recurrent and highly stereotypical limb movements during sleep. These activities are common in the lower extremities, with epileptic contractions of the tibialis anterior muscle. It is characterized by a rhythmic extension of the big toe, a dorsiflexion from the calf joint, and occasional partial flexion of the knee and hip joints.
The incidence of periodic limb dyskinesia in the elderly population is as high as 20% to 60%. It is common for the calf anterior muscle to contract, the big toe to rhythmically stretch, and occasionally the knee and hip joints to bend. These actions can occur once every 20 to 40 seconds, each time lasting for 0.5 to 5 seconds, at least three times in a row. Severe dyskinesia often causes the patient to wake up.
Examine
Periodic examination of dyskinesia
Due to the advancement of sleep research, medical personnel have made great progress in understanding the pathology and etiology of sleep disorders. Brainwave records and electrical and physiological records of other body parts can assist physicians in understanding the patient's sleep physiology dynamics to complement clinical assessment deficiencies. A number of sleep electrograms, in addition to recording the brainwave changes of the patient's nighttime sleep, including the synchronization of heartbeat, respiration, blood gas concentration, physical activity, etc., sometimes including the gastrointestinal motility and the pH of the esophagus, or It is a sexual function test for night erection. However, the need to include several tests must also depend on their clinical diagnosis.
Diagnosis
Diagnosis and identification of periodic limb dyskinesia
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
(1) sedation can not be: most of the long-term use of anti-psychotic drugs and anti-drugs, the adverse reactions, sometimes even a small amount can be used, patients often complain of their anxiety, legs and feet can not land, serious patients often stand repeatedly, Walking back and forth, the symptoms are more pronounced at night than during the day. Use anti-anxiety treatment is effective.
(2) Restless legs syndrome: Foreign surveys show that the prevalence rate is 1% to 10% of the total population. The prevalence rate in China is estimated to be around 1.2% to 5%, which is more common in middle-aged and elderly people. The main manifestation of this disease is an abnormal feeling that is difficult to describe in the lower extremities. Patients often reflect tingling, burning or itching in the bone marrow of the two legs, and often feel comfortable after walking or kneeling. . In severe cases, getting up and walking can only ease, resulting in a bad night break.
(3) painful leg and moving toes: pain in the lower limbs and feet, accompanied by discomfort, characteristic involuntary movement of the toes, one limb or both limbs can appear, this patient Abnormal pain can occur in the lower extremities and can often persist. The involuntary movement of the lower limbs is mainly manifested by the flexion of the toes and the internal and external rotation, the flexion and extension of the joints of the feet, and the nature and characteristics of the pain of restless leg syndrome. Common in heel pain, low back pain, sciatica and other diseases of the medulla and nerve endings.
(4) Acroparesthesia: numbness in the fingers and fingers in nighttime sleep, acupuncture-like pain, often awakened by pain. Adult women are more common. Occurs at the end of the lower limbs.
