Sleep Disorders and Medicine

Biography

Biography: Sona Nevsimalova

Abstract

Diagnostic evaluation of abnormal movements in sleep covers up to 40% of all video-polysomnographic (v-PSG) examinations evaluated in our Sleep labin the past 15 years. Th e main categories were parasomnias and abnormal movement disorders in sleep and their diff erentiation from epilepsy. Childhood NREM parasomnias are regarded as a common and usually benign disorder. Our fi ndings showed a considerable percentage of perinatal risk factors and developmental comorbidities (motor coordination delay, dysphasia, learning and/or behavior disorder) in the aff ected children. Stereotypic behavior in abnormal developmental movements in sleep (bruxism, rhythmic movements) was also found to be a common feature of NREM parasomnias. Th erefore, a disorder of sleep maturation can be supposed to have a role to play in the clinical manifestation of childhood NREM parasomnias. REM parasomnias, mainly REM behavior disorder, are frequently underdiagnosed conditions in children.A connection with childhood narcolepsy will be mentioned. Th e diagnostic diffi culties can sometimes arise from abnormal movements in sleep. Benign neonatal sleep myoclonus as well as rhythmic movement disorder can sometimes be mistaken for epileptic involvement. Bruxism is very common in children can exceptionally be a sign of temporal lobe epilepsy. Epileptic discharges related to arousal instability and periodic leg movements have been described too. Abnormal movements can be connected also with childhood cataplexy attacks. A typical “cataplectic facies” with repetitive mouth opening, tongue protrusion and drooping eyelids appearing close to the disease onset in young children is a frequent feature. Th ese abnormal movements include also positive as well as negative myoclonic jerks aff ecting the neck and upper extremities. Diffi culties in distinguishing some paroxysmal motor events in sleep will be discussed, a series of diverse video-recordings will be shown and a general account of the history and clinical examination together with v-PSG analysis will be presented.