new question archer - sadhan

[ArchivalUser]

A 36 year old man presents to your office for an annual health examination. During review of systems, he reports feeling excessively sleepy during the day and forgetful at work. He states no matter how much he slept, it does not make him feel rested in the morning. He denies snoring at night. He is athletic and maintains his body weight in a healthy range. He denies alcohol consumption, smoking or excessive caffeine use. His girlfriend reports that he abruptly moves his legs often during the night and that disturbs her as well. She has noticed him flexing his leg and extending his great toe repeatedly. The patient is not aware of this and he denies any pain or discomfort in his legs. Physical examination is unremarkable. Laboratory investigations including complete blood count, serum creatinine, electrolytes and a thyroid stimulating hormone are within normal limits. Which of the following is the most likely diagnosis?
A) Complex Partial Seizures
B) Restless leg syndrome
C) Nocturnal Leg Cramps
D) Myoclonus
E) Periodic Limb Movement Disorder
F) Sleep Apnea

[ArchivalUser]

sounds like B but i am sure its not B as pts with restless leg syndrome primarily complain of pain, this pt is not aware of what he does at night. it sounds unusual for complex partial seizures to occur at the same time ever night. nocturnal leg cramps, again , there would be cramps n pain. myoclonus would present with spastic muscles. its not even sleep apnea.... so, i think its E

[ArchivalUser]

ee
people with restless leg synd complain of pain
but people of restless leg synd dont know about the problem

[ArchivalUser]

Answer --E

Periodic limb movement disorder is nocturnal myoclonus which occurs involuntarily

And this is associated with excessive day time sleepiness .

[ArchivalUser]

eee thanks krithi

[ArchivalUser]

E
there is day time sleepiness in both RLS and PLMD.
but PLMD there is no insight.


gl