Polygraphic sleep studies in subacute sclerosing panencephalitis

Abstract

As a measure of the brain's homeostatic functions quantitative analysis of sleep cycles and stages may show more reliably than clinical-neurological investigations changes or progression in the course of generalized central nervous disease. This technique was applied to study the course of SSPE and to provide a neurological parameter in a therapeutic trial with lymphocyte transfer factor. Whole night polygraphic recordings were done in 12 patients with SSPE before and after transfer factor repeatedly over 4 weeks to 1 year. The normal pattern of REM- and NREM-sleep disappeared early in the course of the disease. Disappearance of rapid eye movements showed involvement of mesencephalic pontine structures, absence of sleep spindles thalamic alteration. In 10 patients two alternating states remained, discernible by EEG pattern, heart rate, degree of jerking and degree of correlation between EEG bursts, respiratory phase and heart rate Alternation of these 2 patterns became increasingly rapid and irregular in fast deteriorating cases and were extremely slow in more chronic cases. No cyclic changes were seen in one peracute and in one “burnt out” case. Application of transfer factor had no effect on the deterioration of sleep cycle organization.