Hydroxyzine Hydrochloride in Familial Restless Legs Syndrome
Notice bibliographique
Résumé
Restless legs syndrome (RLS) is a common neurological disorder characterized by nocturnal motor restlessness accompanied by lower limb paresthesias usually alleviated by activity. 1 A dopaminergic dysfunction has been hypothesized.1,2 Several classes of drugs showed beneficial effects on RLS, and ferrum replacement may be effective in iron-deficient patients.2 Here, we present the case of three related patients suffering from RLS, successfully treated with hydroxyzine hydrochloride, an antihistamine with anticholinergic properties. CASE REPORTCase 1 is a 79-year-old woman who has been complaining of irresistible urge to move the legs at rest and at night, for eight years. 1 She reported that the urgency was alleviated only by the movement of the legs, so that every night she was forced to get up and walk all over the room.Her neurological examination was normal and the RLS rating scale score was 26. 3 In order to exclude ischemic involvement of the basal ganglia, a condition rarely associated with RLS, 4 we performed brain MR, which showed bilateral diffuse areas of hyperintensity of the cerebral white matter on T2-weighted images, and no lesions in the basal ganglia.The EMG with nerve conduction study was not significant.Slightly low ferritin was replaced after supplementation, but no changes on RLS symptoms were noted.Pramipexole (1.0mg salt three times/day for two months) and levodopa/carbidopa (200mg/50mg twice/day for two months) were subsequently prescribed with no effect on RLS.Gabapentin (300mg three times/day for approximately three months) and carbamazepine (200mg/day for three months) were useless and caused side effects: poor concentration and weakness; benzodiazepines, such as prazepam (20 mg/day for two months) and lorazepam (2.5mg/day for one month), were ineffective.5 Hydroxyzine hydrochloride, at the dosage of 25 mg, was started, without remarkable side effects.6 Only slight disturbances in nocturnal sleep during the four-month therapy were reported (score 6 on the RLS scale) and the drug discontinuation was followed by the immediate recurrence of RLS symptoms.The paternal grandfather of Case 1 married, for a second time, a first-degree cousin and their daughters (Case 2 and Case 3) showed a clinical picture consisting of nocturnal walking urgency and tickling sensation of the legs.Case 2, a 65-year-old woman, did not show any remarkable diseases in her clinical history, except for primary insomnia.One year before our examination, she started complaining of two or three awakenings, due to motor restlessness and legs discomfort Hydroxyzine Hydrochloride in Familial Restless Legs Syndrome
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Prédiction machine sur la base complète
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».