Objective: To report a case of refractory restless legs syndrome (RLS) in a hemodialysis patient with renal failure who achieved significant symptom and sleep improvement after ultrasound-guided stellate ganglion block (SGB).
Background: RLS prevalence is markedly higher in end-stage renal disease (ESRD) patients, severely impairing sleep and function. Conventional dopaminergic agents often show poor efficacy or contraindications in this population. SGB may offer a novel therapeutic option by modulating sympathetic hyperactivity and immune-inflammatory responses.
Method: A 65-year-old man on regular hemodialysis with 2 years of typical RLS symptoms (nocturnal leg movements, paresthesia, irresistible urge to move, partial relief with activity; mild daytime symptoms) discontinued dopaminergic agents due to poor efficacy and intolerance. He had severe sleep onset and maintenance issues with daytime fatigue. IRLS score was 34 (very severe). After informed consent, he received alternating bilateral ultrasound-guided SGB with 5 mL of 0.5% ropivacaine every other day for 6 sessions.
Results: At 1-week and 1-month follow-up, the patient reported marked reduction in leg discomfort and involuntary movements. IRLS score decreased from 34 to 8 at 1 week and 10 at 1 month. Sleep initiation, nocturnal awakenings, and daytime energy/function improved significantly. No adverse events (infection, hematoma, nerve injury, local anesthetic toxicity, hoarseness, Horner syndrome) were observed.
Conclusion: This case suggests ultrasound-guided SGB can significantly improve symptoms and subjective sleep quality in refractory renal failure-associated RLS with a favorable safety profile. For renal failure-related RLS patients with poor response or contraindications to conventional pharmacotherapy, SGB may be a promising intervention. The mechanism may involve modulation of sympathetic tone and immune-inflammatory status. Further large-scale studies are needed to validate efficacy and long-term outcomes.
To cite this abstract in AMA style:
Z. Zhang. Stellate Ganglion Block for Restless Legs Syndrome in a Patient with Renal Failure a Case Report [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/stellate-ganglion-block-for-restless-legs-syndrome-in-a-patient-with-renal-failure-a-case-report/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/stellate-ganglion-block-for-restless-legs-syndrome-in-a-patient-with-renal-failure-a-case-report/