Introduction: The non-motor symptoms (NMSs) in Parkinson's disease (PD) patients have greater effects on their quality of life compared to the motor symptoms; however, they are under-recognized. The aim: The study aims to evaluate the prevalence and severity of NMS in newly diagnosed PD patients in Tanta University hospitals. Patients and methods: The study included 41 newly diagnosed PD patients. All patients were screened for NMS by the non-motor symptoms questionnaire (NMS-Quest). According to the NMS-Quest response, patients were further evaluated by Sialorrhea Clinical Scale for PD (SCS-PD), Scales for Outcomes in Parkinson's disease for Autonomic symptoms (SCOPA-AUT), Rome III Questionnaire, Nocturnal voiding and Sleep-Interruptions Questionnaire, Brief Pain Inventory, Montreal Cognitive Assessment (MoCA), Scale for Evaluation of Neuropsychiatric Disorders in Parkinson's Disease (SEND-PD), Pittsburgh Sleep Quality Index (PSQI), and questionnaires based upon the International Restless Legs Study Group criteria. The results: The study included 22 female and 19 male patients; the duration of illness was 2.7 ± 2.08 years. Constipation was the most common symptoms as it was present in 73.1% in the studied patients; 61% suffered loss of sexual interest. 47.5% of patients had depressive symptoms. Sleep disturbance was present in 36.6% of the patients. Anxiety was reported by 30% of the patients. Conclusion: All newly diagnosed PD patients suffered one or more NMSs; constipation was the most frequent followed by sexual dysfunction, depressive symptoms, and sleep disturbance, while pain, sialorrhea, and restless leg were the least reported.
BackgroundThe sensori-motor manifestations of Guillain Barré Syndrome (GBS) are usually severe enough to mask the psychiatric and sleep problems which are in need for more attention for better functional outcome.MethodsThis study was performed on 20 GBS patients and 10 healthy controls. Patients were evaluated initially before immunotherapy using the Overall Disability Sum Score (ODSS), Neuropathy Pain Scale (NPS), Hamilton Anxiety Scale (HAS), Montgomery–Åsberg Depression Rating Scale (MADRS) and one-night polysomnography (PSG) followed by the multiple sleep latency test (MSLT) to evaluate the mean sleep latencies. Reevaluation was done using the same parameters 1 month after completing immunotherapy.ResultsThe study showed significant increase in HAS in GBS patients which were positively correlated with the degree of motor disability. The mean sleep latencies of MSLT were significantly shortened and PSG showed shortening of the total sleep time, sleep efficiency, lowest O2 saturation and pulse transit time with increased wake after sleep onset, sleep stage transition index, apnea hypopnea index, desaturation index, arousal index, snore index and periodic limb movement index. One month after immunotherapy, the anxiety symptoms and sleep abnormalities showed non-significant improvements which were not correlated with the improvements in the sensori-motor manifestations.ConclusionsGBS patients usually have sleep and psychiatric abnormalities which may take longer time to improve than the sensori-motor manifestations. So, they need more attention in the management protocol for early patients’ independence and return to usual daily activities.
BackgroundDisordered sleep breathing is a common complication of diabetic peripheral neuropathy (DPN) manifested by excessive daytime sleepiness, morning headache, morning dizziness, cognitive decline, and mood changes.MethodsThis study was performed on 30 non-obese type 2 diabetic patients; 20 with clinically evident DPN and 10 without. Ten age-, sex-, and body mass index-matched healthy control subjects were also included. Patients and control were subjected to history taking, neurological examination, glycated hemoglobin, and clinical assessment of the sensori-motor manifestations by the neuropathy symptom score and neuropathy disability score. The autonomic nervous system was evaluated clinically by the systolic blood pressure response to standing and heart rate response to each of standing, Valsalva, and deep breath. Finally, sleep was assessed by one-night polysomnogram (PSG) followed by multiple sleep latency test in the next day.ResultsThe study showed significant increase in sleep apnea syndromes in diabetic peripheral neuropathy patients compared to diabetic neuropathy free patients and healthy control (p < 0.0001). The sleep apnea was mainly obstructive and to a little extent mixed (obstructive/central) sleep apnea. The severity of sleep PSG abnormalities was positively correlated with the severities of sensory, motor, and autonomic manifestations.ConclusionsNon-obese type 2 diabetic patients complicated by peripheral neuropathy especially those having dysautonomia are at increased risk of developing sleep disordered breathing resulting in their excessive daytime sleepiness, decreased productivity, and poor glycemic control.
Background: Migraine is a primary headache that commonly starts in childhood and adolescent's periods with great negative impacts on the educational and psychosocial performances of its sufferers. The objectives of this work were to study the existence and types of sleep and psychiatric abnormalities in school-age children with migraine (SCM). Methods: The study was conducted on 40 SCM and 20 age-and sex-matched healthy control subjects (HCS) submitted to history taking, neurological examination, Pediatric Migraine Disability Assessment (PedMIDAS) questionnaire, Child Behavior Checklist (CBCL), Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), Pittsburgh Sleep Quality Index (PSQI) and one-night polysomnography (PSG). Results: The study showed a high incidence of psychiatric and sleep abnormalities in SCM. The most common psychiatric disorders were anxious depressed symptoms, withdrawal depressed symptoms, social problem, somatic complaints, and attention problems. At the same time, SCM experienced decreased sleep quality, excessive daytime sleepiness (EDS), and PSG abnormalities in the form of decreased total sleep time (TST) and sleep efficiency (SE) in addition to increased sleep latency, wake after sleep onset (WASO), arousal index (AI), and REM sleep without atonia index. Conclusion: Sleep and psychiatric abnormalities are common underdiagnosed pediatric migraine comorbidities greatly reducing headache control and school performance in this very important period of psychosocial development.
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