Restless Leg Syndrome (RLS) in Multiple Sclerosis: Occurrence and frequent manifestation with neuropathic pain and phasic spasticity (P3.367)

Objective: Restless leg syndrome (RLS) is frequently associated with MS. Therefore we investigated the occurrence and manifestation of RLS in relation to other pain syndromes. Background: RLS is often preceded, accompanied or followed by neuropathic pain or phasic spasticity Design/Methods: We followed 130 consecutive patients, 86 women and 44 men with a mean age of 58,5 years (min. 31; max. 81 years) between 2010 and 2016 with definite RLS fulfilling all four diagnostic criteria (IRSSG). Results: In one patient RLS began within the first year after first symptoms of MS, in 19 patients the latency between first symptoms of MS and RLS was below 5 years. In 88 patients RLS was diagnosed between 5 and 10 years after MS onset, in 2 patients 30 years after first symptoms of MS and beyond an age of 65 years. Very different manifestations of RLS in MS were found: In one female MS patient a unilateral RLS in the left leg occurred preceded by ipsilateral dysaesthetic limb pain with allodynia and later on phasic flexor spasticity. As first symptom RLS was reported by 80, as second by 38 patients. Neuropathic pain in lower extremities was first manifestation in 41 and second in 18 patients. Painful phasic spasticity reported 9 patients as primary manifestation and 13 as second. While 38 patients had at least two of these symptoms, the symptom trias (RLS with neuropathic pain and painful phasic spasticity) was found in 20 patients. Conclusions: The occurrence and manifestation of RLS showed a very high variability in MS patients. Therefore it is necessary to detect signs and symptoms of RLS beside other symptoms of multiple sclerosis as soon as possible after its first onset. This supports therapeutical decisions in these patients to optimize their quality of life in avoiding inefficient drug intake and loss of time. Disclosure: Dr. Poellmann has received personal compensation for activities with Biogen, Genzyme, and Novartis as a speaker. Dr. Feneberg has received personal compensation for activities with Almirall, Bayer, Biogen Idec, Genzyme, Novartis and Sanofi-Aventis as speaker and consultant. Dr. Koehler has received personal compensation for activities with Almirall, Bayer, Biogen Idec, Genzyme, Merck Serono, Novartis, Roche, Sanofi-Aventis, and TEVA as a speaker and from Allmiral, Genzyme, Novartis and Ro as a consultant.