Pathological Yawning in Patients with Acute Middle Cerebral Artery Infarction: Prognostic Significance and Association with the Infarct Location

• Published in: Balkan medical journal 2020-01, Vol.37 (1), p.24-28
• Main Authors: Aksoy Gündoğdu, Aslı, Özdemir, Atilla Özcan, Özkan, Serhat
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; anterior cerebral circulation; Chi-Square Distribution; Cross-Sectional Studies; Female; Humans; infarct location; Infarction, Middle Cerebral Artery - classification; Infarction, Middle Cerebral Artery - physiopathology; Male; Middle Aged; middle cerebral artery infarction; Original; pathological yawning; Prognosis; Severity of Illness Index; Statistics, Nonparametric; Stroke - classification; Stroke - physiopathology; Tıp; Yawning - physiology
• ISSN: 2146-3123; 2146-3131
• DOI: 10.4274/balkanmedj.galenos.2019.2019.7.49

Pathological yawning is a compulsive, frequent, repetitive yawning triggered by a specific reason besides fatigue or boredom. It may be related to iatrogenic, neurologic, psychiatric, gastrointestinal, or metabolic disorders. Moreover, it could also be seen in the course of an ischemic stroke. To determine whether pathological yawning is a prognostic marker of middle cerebral artery stroke and evaluate its relationship with the infarct location. Cross-sectional study. We examined 161 patients with acute middle cerebral artery stroke, consecutively admitted to emergency department. Demographic information, stroke risk factors, stroke type according to Trial of Org 10172 in Acute Stroke Treatment classification, blood oxygen saturation, body temperature, blood pressure, heart rate, glucose levels, daytime of stroke onset, National Institutes of Health Stroke Scale score (National Institutes of Health Stroke Scale score, at admission and 24 h), modified Rankin scale (at 3 months), and infarct locations were documented. Pathological yawning was defined as ≥3 yawns/15 min. All patients were observed for 6 hours to detect pathological yawning. National Institutes of Health Stroke Scale score >10 was determined as severe stroke. The correlation between the presence of pathological yawning and stroke severity, infarct location, and the short- and long-term outcomes of the patients were evaluated. Sixty-nine (42.9%) patients had pathological yawning and 112 (69.6%) had cortical infarcts. Insular and opercular infarcts were detected in 65 (40.4%) and 54 (33.5%) patients, respectively. Pathological yawning was more frequently observed in patients with cortical, insular, and opercular infarcts (p