Periodic Movement Disorder Research Articles

Quetiapine-induced behavioral disorder during sleep.

Quetiapine-induced behavioral disorder during sleep.

F167. Usefulness of combined surface polymyographic and back averaging techniques as essential tools in the evaluation of axial myoclonus of propriospinal origin: Two case presentation

Introduction Propriospinal Myoclonus (PSM) was first described as flexion or extension nonrhythmic repetitive myoclonic jerks arising in axial muscles, spreading to more caudal and rostral segments. Electrophysiologic features include a fixed pattern of muscle activation, slow conduction velocity, EMG burst duration of less than 1.000 ms, synchronous activation of agonist and antagonist muscles, and no facial involvement. The purpose of our study is to describe the usefulness of surface polymyography (sPMG) and jerk-lock techniques in the diagnosis of PSM. Methods Two patients with an involuntary periodic movement disorder were examined. Case 1: Patient underwent sPMG, back averaging and SSEPs testing. For jerk lock averaging, EMG with parallel EEG was registered from tibialis anterior (TA) muscle. SPMG activity was recorded with electrodes placed on paraspinalis dorsalis (PD) and lumbaris (PL), rectus femoris (RF), TA, and gastrocnemius (GM) muscles. The activity was scored for order of muscle recruitment, consistency of activation of the first muscle, consistency of pattern of spread of muscles involved, burst duration, and synchronous co-contraction muscle activation. Case 2: Back averaging, sPMG and SSEPs recordings were performed. For back averaging, sPMG was recorded from masseter, deltoideus, rectus abdominis (RA), PD, PL, RF and TA muscles. Triggers were set at burst onset of the initial muscle. SPMG recording muscles and study parameters were alike to the previous case, except that rectus abdominis rostral (RARA) and caudal aspect (RACA) muscles were added. Results Case 1: A 55-years old male presented with persistent jerks and involuntary lower limbs twitching. Awake and daytime sleep EEG did not show time-locked cortical correlate activity. SSEPs recordings were normal. During sPMG, burst activity started at PL muscle spreading upward to PD muscles and downward to right RF, TA and GM muscles. EMG burst occurred irregularly every 20–60 s, with duration of 100–800 ms. Case 2: A 60-years old male presented with excessive daytime sleepiness due to an acute onset of sudden abdominal jerks at the sleep- wake transition time. All jerks occurred at the transition from wake to sleep, and there were not Bereitschaftspotential preceding spontaneous activity. Burst started in RACA with rostro-caudal propagation. SPMG confirmed activation of the first muscle and consistency of pattern of spread. Jerks occurred irregularly every 20–60 s, with 100–800 ms duration. Co-contraction was evident. The latency of jerks recorded from RACA to RARA and from PD to TA was 55 ms and 95 ms, allowing calculation of spinal conduction velocity, found to be 9.1 ms−1 and 8.6 ms−1. SSEPs recordings were normal. Conclusion PMS is a rare movement disorder that arises from a spinal generator, with rostro-caudal propagation, which shows a typical electrophysiological pattern. We praise the using of sPMG to assess recruitment variability, combined with back averaging recordings to help to establish the diagnosis.

Benign and Periodic Movement Disorders in 2 Children With Down Syndrome

Children with Down syndrome show hypotonia and ligamentous laxity that are associated with motor development delay. Neurologic disorders are common in children with Down syndrome; however, in literature the presence of periodic movement disorders has not yet been described. We report 2 different types of periodic movement disorders in 2 infants with Down syndrome. In the first case, we described an 8-month-old girl with involuntary head nodding and absence of any other neurologic or ophthalmologic abnormalities. In the second case, we described a 6-month-old boy with abnormal but painless head rotation and inclination, alternating from side to side. Episodes of head tilting were often associated with a state of general uneasiness. Neurologic examination between attacks was normal. The aim of this paper is to provide practical information on recognition and management of movement disorders in Down syndrome.

Bruxismo do sono: possibilidades terapêuticas baseadas em evidências

INTRODUÇÃO: o bruxismo do sono (BS) é uma desordem de movimentos estereotipados e periódicos, associados ao ranger e/ou apertar de dentes durante o sono, decorrentes da contração rítmica dos músculos mastigatórios. Essa condição não é uma doença, porém quando exacerbada pode ocasionar desequilíbrio e alteração das estruturas orofaciais. Dessa forma, surge a necessidade de se obter terapêuticas efetivas e seguras para o controle e o manejo do paciente bruxômano. As alternativas de tratamento variam desde terapêuticas orodentais e farmacológicas até técnicas comportamentais-cognitivas. OBJETIVOS: através de uma revisão sistemática da literatura, tendo como bases de pesquisa a Medline, Cochrane, Embase, Pubmed, Lilacs e BBO, no período compreendido entre 1990 e 2008, e com enfoque em estudos clínicos randomizados e quasi-randomizados, revisões sistemáticas e meta-análises, esse trabalho teve como objetivo analisar e discutir métodos de tratamento para o BS. RESULTADOS: pela análise da literatura verifica-se que existe uma grande quantidade de opções terapêuticas para o BS, porém muitas das terapias não têm suporte científico que as sustente. Assim, a escolha terapêutica deve ser pautada em evidências científicas e no bom senso clínico, objetivando uma melhora na qualidade de vida do paciente bruxômano.

EFFECTS OF DRUGS ON SLEEP

Many commonly prescribed medications and substances of abuse can have significant effects on sleep and wakefulness. Chronic use or abuse of certain drugs may lead to the development of substance-related sleep disorders. Primary sleep disorders, such as apnea, periodic movement disorders, and parasomnias, may be exacerbated by various drugs. This article summarizes the effects of widely used medications and recreational drugs on sleep.

EFFECTS OF DRUGS ON SLEEP

Many commonly prescribed medications and substances of abuse can have significant effects on sleep and wakefulness. Chronic use or abuse of certain drugs may lead to the development of substance-related sleep disorders. Primary sleep disorders, such as apnea, periodic movement disorders, and parasomnias, may be exacerbated by various drugs. This article summarizes the effects of widely used medications and recreational drugs on sleep.

Sleep disturbance in chronic fatigue syndrome

Sleep and fatigue characteristics were evaluated in 72 patients who met major criteria for the chronic fatigue syndrome (CFS), 57 multiple sclerosis (MS) patients preselected for fatigue complaints, and 40 healthy controls. Using previously validated rating scales, CFS patients had significant elevations in fatigue and sleep disturbance compared to the MS and healthy control groups. To confirm these subjective measures, polysomnography was carried out in a subgroup of CFS patients who included sleep disturbance as one of their symptoms on initial clinical interview. In 10 of 16 (62.5%) polysomnography revealed clinically significant and potentially treatable sleep abnormalities. Their sleep disorders included periodic movement disorder (4), excessive daytime sleepiness (3), apnea (2), and narcolepsy (1). We conclude that subjective sleep disturbance is common in CFS and some CFS patients may have objective sleep disorders.