Huzursuz Bacaklar Sendromu İle İlişkili Ruhsal ve Tıbbi Bozukluklar: Kısa Bir Derleme

Öz

Huzursuz bacaklar sendromu (HBS), diğer adıyla Willis-Ekbom hastalığı, istirahat halindeyken bacakları hareket ettirme konusunda karşı konulamaz bir dürtü, hareket ettirildiğinde semptomların kısmen veya tamamen rahatlaması ve gece kötüleşmesi ile karakterizedir. HBS, genel popülasyonun %2-10'unda görülür. Ayrıca, toplumda en sık görülen sensorio-motor bozukluklardan birisidir. HBS'nin etiyolojisi halen belirsizliğini korumaktadır. Bu durum, merkezi sinir sistemi (MSS) dopaminerjik disfonksiyonunun yanı sıra, diğer katkıda bulunan mekanizmaları da içerebilir. Tanı klinik özellikler ve Uluslararası HBS Çalışma Grubu’nun önerdiği tanı kriterlerine göre konulur. Tedaviye başlamadan önce, mutlaka altta yatan sekonder sebepler araştırılmalıdır. HBS varlığı, duygudurum bozuklukları (depresyon ve bipolar bozukluk), şizofreni, anksiyete bozuklukları, panik bozukluğu, obsesif-kompulsif bozukluk, intihar etme eğilimi, kendine zarar verme davranışı ve patolojik kişilik özellikleri de dahil olmak üzere çeşitli psikiyatrik bozukluklarla ilişkilidir. Ayrıca, HBS tek başına veya kardiyovasküler hastalık, diyabet ve arteriyel hipertansiyon gibi eşlik eden tıbbi durumlarla birlikte ortaya çıkabilir ve bu da tedavi yönetimini zorlaştırır. Hafif formlarda farmakolojik olmayan tedaviler, orta ve şiddetli formlarda ise dopamin agonistleri, antikonvülzanlar, opioidler ve benzodiazepinler gerekli olmaktadır. Bu çalışmada, HBS tanı, ayırıcı tanı ve psikiyatrik ve tıbbi komorbiditeler yönünden kısaca gözden geçirilmesi amaçlanmıştır.

Anahtar Kelimeler

• etyoloji
• psikiyatrik bozukluklar
• komorbidite
• medikal hastalıklar
• Huzursuz bacaklar sendromu
• uyku bozukluğu

Mental and Medical Disorders Associated with Restless Legs Syndrome: A Brief Review

Öz

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is characterized by an irresistible urge to move the legs at rest, relief in part or in full upon movement, and worsened symptoms at night. RLS occurs in 2-10% of the general population. It is also one of the most common sensorio motor disorders in the community. The etiology of RLS remains unclear. This may involve central nervous system dopaminergic dysfunction, as well as other contributing mechanisms. Diagnosis is made based on clinical features and the diagnostic criteria recommended by the International RLS Study Group. Before initiating treatment, underlying secondary causes must be investigated. The presence of RLS is associated with a variety of psychiatric disorders, including mood disorders (depression and bipolar disorder), schizophrenia, anxiety disorders, panic disorder, obsessive-compulsive disorder, suicidal tendencies, self-harm and pathological personality traits. Also, RLS can present alone or with comorbid medical conditions such as cardiovascular disease, diabetes, and arterial hypertension, complicating treatment management. Non-pharmacological treatments are necessary for mild forms, while dopamine agonists, anticonvulsants, opioids, and benzodiazepines are required for moderate and severe forms. The aim of this study is to provide a brief overview of RLS in terms of diagnosis, differential diagnosis, and psychiatric and medical comorbidities.

Anahtar Kelimeler

• Restless Legs Syndrome
• etiology
• psychiatric disorders
• co-morbidity
• medical disorders
• sleep disorder

Kaynakça

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