| Autor: |
Stiasny-Kolster, Karin, Kohnen, Ralf, Carsten Möller, Jens, Trenkwalder, Claudia, Oertel, Wolfgang H. |
| Zdroj: |
Movement Disorders; Sep2006, Vol. 21 Issue 9, p1333-1339, 7p |
| Abstrakt: |
We developed and validated a standardized test procedure to evaluate the accuracy of the supportive diagnostic criterion 'response to dopaminergic treatment' in restless legs syndrome (RLS). Forty-eight patients who fulfilled at least three of the four essential criteria for RLS, thus including uncertain clinical cases for a nonexpert, were recruited. Patients received a preliminary diagnosis of RLS or non-RLS. All patients underwent a polysomnography (PSG) and were then asked to perform the diagnostic L-DOPA test at home, which consisted in the application of one single dose of 100/25 mg L-DOPA/benserazide and a subsequent observational period of 2 hours. Before, and in 15-minute intervals after, drug intake, the patients rated the severity of the 'symptoms in the legs' and the 'urge to move the legs' using a 100-mm visual analogue scale. Considering a 50% improvement as a positive test result, we found a sensitivity of 88% ('symptoms in the legs') and 80% ('urge to move the legs') with a specificity of 100% for both test items. A rate of 90% or 83% of all patients could be correctly diagnosed by the L-DOPA test. Both scales were able to predict the response to dopaminergic agents in the subsequent course of the treatment by 100%. The periodic leg movements arousal index as assessed by polysomnography was less appropriate for the prediction of the correct diagnosis. We recommend the L-DOPA test for diagnostic decision making in all patients with an unclear RLS diagnosis according to the essential diagnostic criteria of the International RLS Study Group. © 2006 Movement Disorder Society [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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