Chapter

They Call Me “Twinkle Toes”

Ai Ping Chua, Li Ling Lim and Nancy Foldvary-Schaefer

in A Case a Week: Sleep Disorders from the Cleveland Clinic

Published on behalf of Oxford University Press

Published in print September 2010 | ISBN: 9780195377729
Published online April 2013 | e-ISBN: 9780199322985 | DOI: http://dx.doi.org/10.1093/med/9780195377729.003.0045
They Call Me “Twinkle Toes”

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Case 43 introduces a 63-year-old woman who presented to the sleep center complaining that her legs had “gone wild” for the past 6 months. Her medical history was notable for diet-controlled hyperlipidemia, fibromyalgia, irritable bowel syndrome, esophageal reflux, and allergic rhinitis, past renal calculi for which she had undergone laser lithotripsy and laparoscopic pyeloplasty, left lower limb deep vein thrombosis after blunt trauma to the leg, and diffuse myalgias and joint pain, for which she had been on steroids for several years, although a workup for rheumatological disorders was negative. She denied abdominal pain, nausea, vomiting, hematemesis, melena, hematochezia, hemoptysis, and easy skin bruisability. She had a hysterectomy 10 years prior that corrected abnormal vaginal bleeding; no hematuria since treatment for renal stones 4 years prior. No history of peripheral neuropathy. Medications included prednisolone, escitalopram, trazodone, pantoprazole, potassium citrate, coumadin, fluticasone, a multivitamin, calcium, and vitamin D supplements. There was no exposure to tobacco and she consumed alcohol rarely. She was enrolled in a preventive cardiology and rehabilitation program and had recently started a regular exercise regimen. She was not a vegetarian but rarely consumed red meat. There was no family history of restless legs syndrome (RLS) or thalassemia.

Chapter.  2954 words. 

Subjects: Neurology ; Sleep Medicine

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