Iranian Red Crescent Medical Journal ORIGINAL ARTICLE The Effect of Selenium Administration on Restless Leg Syndrome Treatment AG Rahimdel1, P Ayatollahi1, A Zeinali 1 , N Mehrabanian 1 , A Mellat-Ardekani1* 1Department of Neurology, Shahid Sadooghi Hospital, Yazd University of Medical Science, Yazd, Iran Abstract Background: Restless leg syndrome (RLS) is defined as an uncomfortable feeling in the limbs which is promi- nently sensed in legs. Dopamine system involvement is considered as the base of RLS’s etiology. Because of safety, anti-oxidant and dopaminergic promoting action of selenium, this study aims to investigate the effect of selenium on restless leg syndrome treatment. Methods: Sixty patients with primary RLS were enrolled in this clinical trial (Irct2011103015943n1). It was based on 3 periods of drug prescription with one month wash out period. As placebo, 50 and 200 µg of selenium were administered in each separated month. The diagnosis was based on criteria published by IRLSG (International RLS Study Group). The questionnaire included 10 questions while each question’s rating was between 0 and 4. Points between 1 and 10 were considered mild, 11 to 20 as moderate, 21 to 30 as severe and 31 to 40 as very severe. After end of each month of drug consumption, questionnaires were completed and each subject was asked to report the severity of disease and side effects of the drugs. At least 10 declines in scale were consid- ered as appropriate responses. Results: Improvement (decline IRLS score >10) was significantly higher in selenium (50 and 200 µg) than pla- cebo group. Conclusion: Selenium prescription in daily recommended dose of 50 µg instead of a dopamine agonist would be an alternative treatment in improvement of RLS symptoms. Keywords: Restless leg syndrome; Selenium; Treatment Introduction Restless leg syndrome (RLS) is defined as an uncom- fortable feeling in the limbs which is prominently sensed in legs and rarely in arms.1 This disturbing feeling leads to restless and forces patient to move the limbs which is pathognomonic manifestation of RLS. This movement leads to complete but temporary relief of symptoms. These symptoms occur only in rest and are intensified in evening or night time.1 The prevalence of disease was shown to be 5-10%.1-3 and the prevalence increased by aging.3 In addition to sensory symptoms, motor symptoms such as periodic limb movement syndrome, myoclonic Jerking exist *Correspondence: Ali Mellat-Ardekani, MD, Assistant Professor of Neurology, Shahid Sadooghi Hospital, Yazd University of Medical Sci- ence, Yazd, Iran. Tel: +98-351-8224001, e-mail: Ali_mellat@ssu.ac.ir Received: May 22, 2011 Accepted: September 14, 2011 during the patient's sleep.1,2 Since these symptoms may occur during sleep, most of patients have some difficulty in start of sleeping or during sleep which may lead to fatigue and excessive daily sleepiness. Thus RLS is one of the most important causes of in- somnia and sleepiness during the day.4 The etiology of RLS is not precisely defined yet but it may be pri- mary (idiopathic) or secondary. Primary cases are commonly genetical and are presented as autosomal dominant patterns.5-8 Secondary types are associated with diseases such as iron deficiency anemia, folic acid deficiency, renal failure and physiological condi- tions such as pregnancy.1,9 Also some case reports showed an association between RLS and diabetes melitus, rhematoid arthritis and amyloidosis.1,9 RLS may be induced secondary to drug consump- tion such as lithium, three cyclic antidepressants, do- pamine blockers like metoclopramide and phenothia- zines.1-3 Some facts such as response to dopaminergic Iran Red Crescent Med J 2012; 14(1):14-19 ©Iranian Red Crescent Medical Journal