A case of restless legs syndrome with cold sensation successfully treated with acupuncture and moxibustion treatment

Abstract

[Objective] We report a patient with restless legs syndrome (RLS) associated with chronic cold sensation in her lower legs. Both symptoms were successfully treated with acupuncture and moxibustion. [Patient] The patient was a 42-year-old female whose chief complaint was unpleasant abnormal sensation on the back of her lower legs that appeared when attempting to sleep. She had previously experienced the same sensation while she was pregnant, but it disappeared after childbirth. The unpleasant sensation appeared again in July, X year with no precipitating cause. The symptoms progressively worsened each day, eventually resulting in sleep disturbance. She was diagnosed as RLS in the department of neurology, but she did not want pharmacotherapy so she decided to start a treatment of acupuncture and moxibustion. She underwent the treatment once a week, with acupuncture in the triceps surae muscle of both lower legs, and an electronic moxibustion at acupoints BL57 and SP6 bilaterally. The International Restless Legs Syndrome Severity Rating Scale (IRLS) and the Numerical Rating Scale (NRS) were used for evaluation. [Result] The IRLS score gradually decreased from 26 to 2 by the 7th treatment. The NRS score also decreased from 8 to 0. The patient's chronic cold sensation also improved with reduction in RLS symptoms. [Discussion] Recently a dysfunction of the dorsoposterior hypothalamic dopaminergic A11 cell group has been implicated in the pathology of RLS. The dysfunction in this system induces an excessive sympathetic activity, which may cause microangiopathies resulting in the cold sensation. [Conclusion] RLS and cold sensation are shared pathologies relating to the dopaminergic and the autonomic nervous system, and our report suggests that acupuncture and moxibustion treatment may have acted upon these systems to improve symptoms.