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