Treatment of restless legs syndrome/Willis-Ekbom disease with selenium

Restless legs syndrome/Willis-Ekbom disease (RLS/WED) is a chronic neurosensory disorder that is characterized by a strong urge to move, accompanied by an uncomfortable paresthesia in the legs which affects about 5-15 percent of adult people in industrialized countries.1 RLS/WED is a puzzling disease, mostly because of the uncertainty of its etiology. There seems to be a genetic component, but it is also known that RLS/WED may be caused by other underlying pathologies and is treated by remedying those conditions. Another highly researched area in the quest to find an etiology and treatment for RLS/WED is the brain dopamine system; in fact, dopaminergic medication is considered the first line of treatment for RLS/WED that is not caused by other underlying factors.1 There is growing evidence, suggesting that selenium plays an important role in many body functions, and seems to be an important regulator of brain function as well.2 Selenium has a strong anti-oxidant action.2 The body concentration of selenium is related to soil concentration, which is low in Sweden. We report the successful treatment of 3 patients with severe RLS/WED with the intake of selenium for 6 months; Three female patients, aged 25-60 years, were all suffering from severe to very severe RLS/WED since childhood. Severity was measured by using the International Restless Legs Scale (IRLS), a 10-item questionnaire developed by the International Restless Legs Syndrome Study Group (IRLSSG).1 Each question has five response options, ranging from “0” to “4”. Hence, the total score can range from “0” to “40”, indicating “no symptoms” to “very severe symptoms”, respectively. The subjects’ IRLS scores were between 25 and 38. The subject with the IRLS score of 25 was being treated with the dopaminergic drug pramipexole, 0.18 mg in the evening. No one was a smoker, and they were healthy and without any other medical treatment or alternative medicine. Height, weight, blood pressure, hemoglobin, the vitamins folic acid and B12, kidney functions and iron status were within normal limits. All 3 patients started to take selenium yeast 100 micrograms daily. This was bought over-theIranian Journal of Neurology