RESUMO
We describe multiple sleep latency test (MSLT) results in 27 adult patients with idiopathic Parkinson's disease (PD). Pathological sleepiness (i.e. mean sleep latency =5 min) was common (40 of 134 nap opportunities), and sleep-onset REM periods were also observed (13 of 134 nap opportunities). These findings bore little relationship to disease specific variables (e.g. level of disability, medication use), or sleep architecture measures (e.g. total sleep time, sleep stage percentage's). Our findings speak against a simple association of excessive sleepiness and the quality and quantity of prior night's sleep, but rather, argue for primary impairments of waking arousal and REM-sleep expression in a sizeable subpopulation of PD patients.
Assuntos
Ritmo Circadiano/fisiologia , Distúrbios do Sono por Sonolência Excessiva/complicações , Doença de Parkinson/complicações , Sono REM/fisiologia , Idoso , Nível de Alerta/fisiologia , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Eletroencefalografia , Eletromiografia , Eletroculografia , Feminino , Humanos , MasculinoRESUMO
We report a 56-year-old man with Huntington's disease whose chorea substantially improved after treatment with electroconvulsive therapy (ECT). ECT should be considered for medically refractory cases of movement disorders, especially those with severe disability.
Assuntos
Eletroconvulsoterapia , Doença de Huntington/terapia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The epidermal nevus syndrome (ENS) is an unusual neurocutaneous disorder consisting of the combination of an epidermal nevus and a central nervous system (CNS), ophthalmological, and/or skeletal abnormality. The study reports four new patients with ENS. Each had a confirmatory biopsy of the epidermal nevus, abnormal neurological examination findings, and documented CNS anatomical studies by imaging or autopsy. The paper also reviews the literature in English to determine neurological abnormalities found in skin-biopsy-proven cases of ENS. Hemi-atrophy, hemimegalencephaly, migrational abnormalities and vascular anomalies were found to be the most frequent intracranial abnormalities associated with ENS. Seizures and/or disabling moderate to severe developmental delays were present in a majority of patients. Seizure onset during the neonatal period or early infancy was associated with major hemispheric malformations. Neuroectodermal-derived ocular lesions were often bilateral. No consistent relation between laterality of the nevus and laterality of CNS abnormalities was found, supporting the gene mosaicism theory of pathogenesis.
Assuntos
Anormalidades Múltiplas , Sistema Nervoso Central/anormalidades , Nevo Pigmentado/patologia , Neoplasias Cutâneas/patologia , Encéfalo/patologia , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Nevo Pigmentado/congênito , Neoplasias Cutâneas/congênitoRESUMO
Epilepsy is a fascinating disorder reflective of ongoing brain activity which at times is disordered. There have been significant advances in the understanding of the pharmacology of antiepileptic drugs such that effective treatment is feasible. Understanding the epilepsies and the phenomena of epileptic seizures will permit one to successfully deal with the major issues around these syndromes and lead to a very rewarding outcome.