Sleep-related rhythmic movement disorder in adults - A systematic review with a case report.

Sleep-related rhythmic movement disorder is characterised by stereotyped and repetitive rhythmic movements involving large muscle groups during sleep with frequencies between 0.5 and 2 Hz. Most of the published studies on sleep-related rhythmic movement disorder have focussed on children. Therefore, we performed a systematic review on this topic focussing on the adult population. The review is followed by a case report. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A total of seven manuscripts (n = 32 individuals) were included in the review. The clinical manifestation of body or head rolling predominated in the majority of included cases (53.13% and 43.75%, respectively). In n = 11 (34.37%) cases, a combination of rhythmic movements was observed. The literature review also revealed a wide spectrum of co-morbidities: insomnia, restless leg syndrome, obstructive sleep apnea, ischaemic stroke, epilepsy, hypertension, alcohol and drug dependency, mild depression, and diabetes mellitus. The case report presented a 33-year-old female who was referred to the sleep laboratory due to a suspicion of sleep bruxism and obstructive sleep apnea. Although the patient was initially suspected of having obstructive sleep apnea and sleep bruxism, after conducting video-polysomnography she met the criteria for sleep-related rhythmic movement disorder as she presented body rolling, which were surprisingly most evident during the rapid eye movement sleep stage. In summary, the prevalence of sleep-related rhythmic movement disorder among adults has not been determined yet. The present review and case report is a good starting point for discussion regarding rhythmic movement disorder in adults and further research on this topic.

Three Cases with Visual Hallucinations following Combined Ocular and Occipital Damage.

Charles Bonnet syndrome is an underrecognized disease that involves visual hallucinations in visually impaired patients. We present the cases of three patients who experienced complex visual hallucinations following various pathomechanisms. In two cases, diagnosis showed coexistence of occipital lobe damage with ocular damage, while in the third case it showed occipital lobe damage with retrobulbar optic neuritis. Theories of pathogenesis and the neuroanatomical basis of complex visual hallucinations are discussed and supported by literature review.

Lambda waves and occipital generators.

The objective of this study was to identify the relationship between lambda waves (LWs) and other occipital waveforms, in a retrospective analysis of electroencephalograms (EEGs) of clinic and hospitalized patients at a single center. The LWs were correlated with α rhythm, photic driving, and positive occipital sharp transients of sleep (POSTS). A computer-generated cursor quantified amplitude and duration of POSTS and LWs (3 waveforms and both hemispheres). Fisher exact test was used for significance (P ≤ .05). A total of 116 patients were evaluated. Of 111 patients, with interpretable results, 74 (66.67%) had visual scanning during EEG, with 37 (50.0%) having LWs. The LWs (17.69 µV) were consistently smaller than POSTS (31.40 µV) despite similar morphology. Patients with an α rhythm of >8.5 Hz were strongly correlated with the presence of LWs (P < .0001), and those with LWs were strongly predictive of normal EEG (P = .001). Of the 37 patients, 27 (73.0%) with LWs had photic driving (P = .0496). No correlation was found between LWs and POSTS (P = .45). The presence of LWs and a low normal posterior dominant rhythm (PDR) suggests intact electrocerebral health. LWs and the photic driving response suggest similar generators but stimulus-specific networks. POSTS differ from LWs despite similar morphology, suggesting different network activation of occipital generators. LWs have clinical significance in excluding encephalopathy. Occipital generators are differentiated by state and stimulus-dependent network activation and not by location and morphology.

Serum biochemical reference intervals for the Polish Konik horse (Equus cabalus gmelini Ant.).

BACKGROUND: Establishment of reference intervals (RI) for serum biochemical analytes is important for monitoring the health of different breeds of horses. OBJECTIVES: The aim of this study was to measure and report RI for serum biochemical analytes of the Polish Konik horse. MATERIAL AND METHODS: Blood samples were collected from 74 clinically healthy Polish Konik horses living under controlled natural conditions. These were adult primitive horses, aged 3-15 years, including 28 males (21 stallions, 7 geldings) and 46 mares. Serum analytes were measured and analyzed using a commercial automated analyzer. RESULTS: The following RI (medians) were comparable to previously published RI in horses: albumin 34.8-41.3 g/L (38.0); ALP 124-309 U/L (216); ALT 6-33 U/L (19); AST 300-566 U/L (433); calcium 2.8-3.2 mmol/L (3.0); chloride 95-102 mmol/L (99); cholesterol 2.1-3.4 mmol/L (2.7); CK 167-488 U/L (328); creatinine 101-170 µmol/L (136); glucose 2.7-5.3 mmol/L (4.0); lipase 303-1143 U/L (723); magnesium 0.8-1.0 mmol/L (0.9); phosphate 0.9-1.5 mmol/L (1.2); potassium 2.4-5.0 mmol/L (3.7); sodium 138-144 mmol/L (141); total bilirubin 8-16 µmol/L (11.7); total protein 63.5-78.9 g/L (71.2); triglycerides 0.0-0.3 mmol/L (0.1); urea 2.2-7.3 mmol/L (4.7). CONCLUSION: Reference intervals established in this study provide a valuable preliminary baseline for assessment of serum analytes in healthy Polish Konik horses.

The influence of road transport on the activities of glutathione reductase, glutathione peroxidase, and glutathione-S-transferase in equine erythrocytes.

BACKGROUND: Transport of horses may have significant impact on serum biochemical and hematologic analytes and resistance to infection. OBJECTIVE: The aim of our study was to assess the influence of transport stress on selected enzymatic antioxidants in equine blood. METHODS: The study was conducted on a group of 60 horses of different breeds and ranging in age from 4 to 10 years. Venous blood was collected immediately before loading horses onto trailers for 8 hours of transport (I), immediately after unloading them from the trailer (II), and after subsequent stall rest for 24 hours (III). Hemolysates of blood were prepared, and hemoglobin (Hb) concentration and activities of the enzymatic antioxidants glutathione reductase (GR), glutathione-S-transferase (GST), and glutathione peroxidase (GPx) were measured. Enzyme activities were expressed as units of activity per gram of hemoglobin. RESULTS: There were significant decreases in activities (mean ± SD U/g Hb [minimum-maximum]) of GPx between collection times I (36 ± 14 U/g Hb [9-67 U/g Hb]) and III (30 ± 11 U/g Hb [12-51 U/g Hb]) and of GR between collection times I (54 ± 28 U/g Hb [7-117 U/g Hb]) and II (40 ± 23 U/g Hb [12-145 U/g Hb]). There was no significant difference in activities of GR between collection times I and III (50 ± 27 U/g Hb [9-116 U/g Hb]). There were no differences detected in GST activity among the 3 collection times. CONCLUSION: Road transport has an impact on activities of the antioxidant enzymes GPx and GR, with recovery of GR activity evident by 24 hours post-transport. Decreased activity of these enzymes may be one mechanism for increased susceptibility to infections that are manifest after shipping; alternatively, decreases may indicate utilization as these enzymes work to neutralize increases in reactive oxygen species.