Article

Case report on the successful treatment with pramipexole in four
men with chronic spinal cord injury (SCI) suffering from refractory symptoms that
were previously considered to be manifestations of a post-traumatic spastic
syndrome or neuropathic pain. OBJECTIVE: To raise awareness among health
professionals regarding the diagnostic and therapeutic possibility of restless
legs syndrome (RLS) and periodic limb movements (PLMs) in some patients with SCI
responding poorly to conventional treatment for spasticity or neuropathic pain.
SETTING: Neurorehabilitation department of the Rehabilitation Medicine Center of
Northern University Hospital, Umea, Sweden. METHODS: Medical records and clinical
data were retrospectively reviewed. RESULTS: All cases obtained treatment with
pramipexole, initially 0.09-0.72 mg day(-1). Two of the cases had RLS and PLMs,
one RLS only and one PLMs only. All four reported symptoms in the lower
extremities and one also in the upper extremities. Three patients with residual
gait function reported RLS score with/without treatment as follows: 32/11, 37/12
and 33/12. One patient with complete paraplegia (with incomplete RLS score)
reported 22/10. After a follow-up period of 16, 20, 43 and 49 months,
respectively, all four still reported excellent outcomes. Two remained on initial
dosage; one had increased dosage from 0.09 to 0.18 mg day(-1) and one from 0.27
to 0.80 mg day(-1) during the follow-up period. CONCLUSIONS: In persons with SCI
suffering from infralesional involuntary movements and/or dysesthesia and with
poor response to conventional antispastic or analgesic treatment, the possibility
of RLS or PLMs should be considered, as these conditions seem eminently
treatable.

Langue : ANGLAIS