Tkachuk N. Clinical and pathogenetic features of restless legs syndrome in patients with diabetic polyneuropathy and their management

The dissertation is devoted to improvement of diagnostic criteria and increase the treatment efficiency of restless legs syndrome in patients with diabetic polyneuropathy on the basis of studying the features of clinical and electrophysiological indicators. The study of clinical symptoms of restless legs syndrome patients affected by diabetic polyneuropathy revealed that paresthesia, pain in lower limbs, their occurrence in longtime sitting and excessive motor activity were common for both pathologies, while limb movements during sleep, need for walking at nighttime, nocturnal awakening and daytime sleepiness were prevalent in restless legs syndrome patients. It was first discovered that the failure of drug therapy in relieving neuropathic pain in diabetic polyneuropathy patients, may serve as an additional criterion for diagnosis of restless legs syndrome. The method of differential diagnostics of restless legs syndrome and diabetic polyneuropathy was first worked out due to turns-amplitude analysis of interferential electroneuromyography, which made it possible to estimate the causes of pathologic afferent activity in lower limbs within a short time, and thus timely prescribe ethiopathogenetic treatment. Consequently, the combined treatment with pramipexole and zopiclone in patients with restless legs syndrome affected by diabetic polyneuropathy showed marked improvement in the clinical course of the disease, and particularly had positive influence on the motor manifestations of restless legs syndrome, thus improving the patients’ quality of sleep, which had positive effect on their life quality.