RESUMO
INTRODUCTION: Brachial plexus is rarely involved in "Saturday night palsy". CASE REPORT: A young man was admitted for numbness and weakness of his right upper limb after awaking from sleep. Neurophysiological studies, consistent with brachial plexopathy, revealed presence of proximal conduction blocks. Patient presented spontaneous clinical and neurophysiological improvement. DISCUSSION: Diagnosis of compressive brachial plexopathy needs to eliminate other causes of neuropathy with conduction block.
Assuntos
Neuropatias do Plexo Braquial/patologia , Síndromes de Compressão Nervosa/patologia , Paralisia/patologia , Paralisia do Sono/patologia , Neuropatias do Plexo Braquial/etiologia , Eletromiografia , Potencial Evocado Motor/fisiologia , Humanos , Masculino , Síndromes de Compressão Nervosa/complicações , Condução Nervosa/fisiologia , Paralisia/etiologia , Recuperação de Função Fisiológica , Paralisia do Sono/etiologia , Estimulação Magnética Transcraniana , Adulto JovemRESUMO
In 1989, we described a new autosomic-recessive myelin-mutant rat that develops a progressive motor syndrome characterized by tremor, ataxia, immobility episodes (IEs), epilepsy, and paralysis. taiep is the acronym of these symptoms. The rat developed a hypomyelination, followed by demyelination. At an age of 7-8 months, taiep rats developed IEs, characterized electroencephalographically by REM sleep-like cortical activity. In our study, we analyzed the ontogeny of gripping-induced IEs between 5 and 18 months, their dependence to light-dark changes, sexual dimorphism, and susceptibility to mild stress. Our results showed that IEs start at an age of 6.5 months, with a peak frequency between 8.5 and 9.5 months. IEs have two peaks, one in the morning (0800-1000 h) and a second peak in the middle of the night (2300-0100 h). Spontaneous IEs showed an even distribution with a mean of 3 IEs every 2 h. IEs are sexually dimorphic being more common in male rats. The IEs can be induced by gripping the rat by the tail or the thorax, but most of the IEs were produced by gripping the tail. Mild stress produced by i.p. injection of physiological saline significantly decreased IEs. These results suggested that IEs are dependent on several biological variables, which are caused by hypomyelination, followed by demyelization, which causes alterations in the brainstem and hypothalamic mechanisms responsible for the sleep-wake cycle regulation, producing emergence of REM sleep-like behavior during awake periods.
Assuntos
Doenças Desmielinizantes Hereditárias do Sistema Nervoso Central/fisiopatologia , Transtornos dos Movimentos/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Fatores Etários , Animais , Tronco Encefálico/patologia , Tronco Encefálico/fisiopatologia , Cataplexia/genética , Cataplexia/patologia , Cataplexia/fisiopatologia , Córtex Cerebral/fisiopatologia , Transtornos da Consciência/genética , Transtornos da Consciência/patologia , Transtornos da Consciência/fisiopatologia , Epilepsia/genética , Epilepsia/patologia , Epilepsia/fisiopatologia , Feminino , Predisposição Genética para Doença/genética , Doenças Desmielinizantes Hereditárias do Sistema Nervoso Central/genética , Doenças Desmielinizantes Hereditárias do Sistema Nervoso Central/patologia , Hipotálamo/patologia , Hipotálamo/fisiopatologia , Masculino , Transtornos dos Movimentos/genética , Transtornos dos Movimentos/patologia , Narcolepsia/genética , Narcolepsia/patologia , Narcolepsia/fisiopatologia , Ratos , Ratos Mutantes , Caracteres Sexuais , Paralisia do Sono/genética , Paralisia do Sono/patologia , Paralisia do Sono/fisiopatologia , Transtornos do Sono-Vigília/genética , Transtornos do Sono-Vigília/patologia , Estresse Psicológico/genética , Estresse Psicológico/patologia , Estresse Psicológico/fisiopatologia , Tremor/genética , Tremor/patologia , Tremor/fisiopatologiaRESUMO
Isolated Sleep Paralysis (SP) occurs at least once in a lifetime in 40-50% of normal subjects, while as a chronic complaint it is an uncommon and scarcely known disorder. A series of messages written by subjects who experienced at least one episode of SP, containing more or less detailed descriptions of this disorder, were collected from the Sleep Web site of the University of California in Los Angeles between January 1996 and July 1998. Two hundred and sixty-four messages fulfilling the International Classification of Sleep Disorders (ICSD) (Thorpy, 1990) minimal criteria for SP were analyzed. A wide spectrum of severity was evident, with a frequency of episodes ranging from one in a lifetime to almost every night, and a variety of emotional and hallucinatory experiences associated with SP episodes were reported. Clinical similarities between the recurrent form of isolated SP and channelopathies (in particular, periodic paralyses) are discussed. An activation of limbic system structures is suggested in order to explain some of the most common subjective experiences associated with SP.
