Phasic motor activity reduction occurring with horizontal rapid eye movements during REM sleep is disturbed in infantile spasms

Single polysomnography was performed before treatment in 17 patients with infantile spasms (IS) (13 with a cryptogenic type and 4 with a symptomatic one). Their sleep components during rapid eye movement (REM) sleep were compared with those in 22 age-matched controls. The tonic muscle atonia during...

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Bibliographic Details
Published in:Journal of the neurological sciences 1996-06, Vol.138 (1), p.82-87
Main Authors: Kohyama, Jun, Ohsawa, Yukiko, Shimohira, Masayuki, Iwakawa, Yoshihide
Format: Article
Language:English
Subjects:
Biological and medical sciences
Brainstem
Case-Control Studies
Female
Follow-Up Studies
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Infant, Newborn
Infantile spasms
Male
Medical sciences
Motor Activity - physiology
Nervous system (semeiology, syndromes)
Neurology
Phasic inhibition
REM sleep
Sleep, REM - physiology
Spasms, Infantile - physiopathology
Spasms, Infantile - psychology
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Summary:Single polysomnography was performed before treatment in 17 patients with infantile spasms (IS) (13 with a cryptogenic type and 4 with a symptomatic one). Their sleep components during rapid eye movement (REM) sleep were compared with those in 22 age-matched controls. The tonic muscle atonia during REM sleep was observed in all IS patients as in controls. The amount of REM sleep in IS patients was significantly lower, while the incidences of gross movements, phasic chin muscle activity, and bursts of horizontal rapid eye movements were identical with those in controls. The phasic inhibition index (PII), i.e., the rate of simultaneous occurrence of phasic chin muscle activity and bursts of horizontal rapid eye movements, was significantly higher in IS than in controls. The PII value was the only parameter that reflected our patients' prognosis among the obtained REM sleep parameters. We presume that the elevated PII in IS reflects the weakness of the phasic motor activity reduction occurring with horizontal rapid eye movements, and attribute this disturbance to a functional instability of the rostral pontine tegmentum. We propose that PII is a useful parameter for assessing the prognosis of IS. Considering the neural basis for elevated PII in IS, this index is expected to provide a clue for explaining the pathophysiology of IS.
ISSN:0022-510X
1878-5883
DOI:10.1016/0022-510X(95)00342-Y