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May 17, 2022; 98 (20) Resident & Fellow Section

Teaching Video NeuroImage: Restless Abdomen

A Rare Variant of Restless Legs Syndrome

Zhanfang Sun, Yinyin Tan, Zhen Li, Liling Yang, Xuedong Sun, Yifeng Du, Yan Chen
First published March 16, 2022, DOI: https://doi.org/10.1212/WNL.0000000000200595
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A 60-year-old man presented with difficulty falling asleep and unpleasant abdominal sensations for over 2 years. His medical history was unremarkable except for benign prostatic hyperplasia. He experienced unpleasant abdominal sensations 30 minutes after lying down, which partially improved after rubbing or slapping his abdomen and walking. He denied symptoms of heartburn or reflux. Hemoglobin, iron, and ferritin were normal. Gastrointestinal endoscopy and abdominal CT were normal. Video-polysomnography revealed an urge to move his abdomen during periods of rest and periodic limb movements of sleep (PLMS) (Video 1). A rare variant of restless legs syndrome (RLS), restless abdomen, was considered.e1 Most patients improve with dopaminergic treatment.1,2 The effectiveness of dopaminergic therapy for RLS, restless abdomen, and PLMS suggests that they may share a similar pathophysiology, although the exact mechanism remains unclear.e2,e3 Our patient has responded well to pramipexole (0.25 mg/d) for 8 months.

Video 1

Restless abdomen in a patient with a sleep disorder. The patient experienced an urge to move his abdomen during periods of rest, which partially relieved unpleasant sensations. Periodic limb movements of sleep were also observed.Download Supplementary Video 1 via http://dx.doi.org/10.1212/200595_Video_1

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No targeted funding reported.

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The authors report no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures.

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Footnotes

  • Received August 21, 2021.
  • Accepted in final form February 16, 2022.

References

  1. 1.↵
    1. Allen RP,
    2. Picchietti DL,
    3. Garcia-Borreguero D, et al.
    Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria—history, rationale, description, and significance. Sleep Med. 2014;15(8):860-873.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Wang XX,
    2. Zhu XY,
    3. Wang Z,
    4. Dong JW,
    5. Ondo WG,
    6. Wu YC
    . Restless abdomen: a spectrum or a phenotype variant of restless legs syndrome? BMC Neurol. 2020;20(1):298.
    OpenUrl
  3. eReferences e1–e3 are in the supplement links.lww.com/WNL/B884.

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