Periodic limb movements in syringomyelia and syringobulbia

Nogués, Martín; Cammarota, Angel; Leiguarda, R; Rivero, Alberto; Pardal, Ana; Encabo, Horacio

doi:10.1002/1531-8257(200001)15:1<113::aid-mds1017>3.0.co;2-y

Cited by 37 publications

(9 citation statements)

References 17 publications

(17 reference statements)

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“…This difference probably was related to degree of spinal cord malformation with hydrosiringomyelia, which involved propiospinal neurons, presented in 40 a 88% of the CM II patients 30 . In accordance with Nogués et al 6 , in CM II patients there is a relationship between the presence of PlMS and spinal cord abnormalities. Abnormalities of the spinal cord may result in hyperexcitability of spinal regions affected by malformations, leading to the appearance of PlMS 6 .…”

Section: Discussionsupporting

confidence: 87%

“…In accordance with Nogués et al 6 , in CM II patients there is a relationship between the presence of PlMS and spinal cord abnormalities. Abnormalities of the spinal cord may result in hyperexcitability of spinal regions affected by malformations, leading to the appearance of PlMS 6 . The CM II patient with severe PlMS index was also affected by attention deficit, reinforcing the hypothesis that some sleep disorders, as PlM, may impair cognitive performance 7 .…”

Section: Discussionsupporting

confidence: 83%

“…Besides the potential presence of cognitive difficulties, CM II patients are, mostly due to their brain stem anomalies, often affected by sleep disorders, the more frequently observed being sleep apneas, central hypoventilation and pulmonary restrictive disease 3,5 . Periodic limb movement in sleep (PlMS) may appear in association to spinal anomalies 6 , and would be another sleep disorder which could result in further cognitive impairment 7 . PlMS in CM II patients were never previously described, although Kaplan and Oksuz 8 reported this disorder in a CM I patient.…”

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confidence: 99%

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Sleep disorder: a possible cause of attention deficit in children and adolescents with Chiari malformation type II

Filho¹,

Pratesi²

2009

Arq. Neuro-Psiquiatr.

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-Background: Attention deficit may be related to sleep disorders in Chiari malformation type II (CMII). Our aim is identify sleep disorders and their specific contribution in attention deficit. Method: We selected 24 patients with CM II and 24 without CM II. DSM-IV criteria and a neuropsychological analysis were applied in all. All patients underwent full night polysomnography. Results: 14 CM II patients presented sleep apnea syndrome, REM sleep behavior disorder and periodic limb movement in sleep; six patients without CM II presented sleep apnea syndrome. Among these patients, 12 (six with CM II and six without CM II) presented attention deficit related to the sleep disorders. Conclusion: Sleep disorders may impair cognitive functions, as attention, and contribute to poor quality of learning also in patients with CM II.KEy WORDS: polysomnography, REM sleep behavior disorder, apnea, cognition, attention deficit disorder. Distúrbios do sono: possível causa de déficit de atenção em crianças e adolescentes com malformação de Chiari tipo IIResumo -Introdução: Déficits de atenção podem estar relacionados a distúrbios do sono em indivíduos com malformação de Chiari tipo II (CM II). Nosso objetivo é identificar distúrbios do sono e sua contribuição para a ocorrência de déficit de atenção. Método: Foram selecionados 24 pacientes com CM II e 24 sem CM II. Todos foram submetidos à avaliação neuropsicológica, aos critérios do DSM-IV e a polissonografia. Resultados: 14 pacientes com CM II apresentaram síndrome da apnéia do sono, distúrbio do comportamento da fase do sono REM e movimentos periódicos dos membros em sono; seis pacientes sem CM II apresentaram síndrome da apnéia do sono. Entre estes pacientes, 12 (seis com CM II e seis sem CM II) apresentaram déficit de atenção relacionado a distúrbios do sono. Conclusão: Distúrbios do sono podem prejudicar funções cognitivas, como a atenção, contribuindo para a piora da qualidade de aprendizado também em pacientes com CM II.PAlAVRAS-ChAVE: polissonografia, distúrbio do comportamento da fase do sono com movimentos oculares rápidos, apnéia, cognição, transtorno do déficit de atenção. The central nervous system (CNS) abnormality characterized by herniation of cerebellar tonsils below the plane of foramen magnum was initially described by Chiari in 1891. Subsequently, the same author expanded the spectrum of abnormalities of the craniocervical junction including disorders that are currently recognized as Chiari malformation (CM) type I, II, III and IV. These congenital disorders disclose complex physical and neuropsychological symptomatology and are associated with developmental anomalies of both the spine and brain 1 . The CM type II (CM II) is characterized by the descent of the inferior vermis and cerebellar hemispheres through the foramen magnum with a displacement of the brain stem (medulla, fourth ventricle, and lower portion of the pons) inside the spinal canal, resulting in aqueduct and fourth ventricle elongation 1,2 . Myelomeningocele is present in almost all c...

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 83%

mentioning

confidence: 99%

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Sleep disorder: a possible cause of attention deficit in children and adolescents with Chiari malformation type II

Filho¹,

Pratesi²

2009

Arq. Neuro-Psiquiatr.

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“…It is commonly admitted that latency from stimulus to jerk above 100 msec may be suggestive of psychogenic jerks. However, long latency (range 60 to 150 msec) responses to various stimuli have been reported in patients with PSM, 2,8,17,19,27 including patients with obvious conventional spinal MRI abnormalities, such as syringomyelia, arteriovenous fistula, and demyelinating lesions. 8,17,19 Therefore, we considered that the reproducible although long latency responses recorded in our patients, ranging from 90 to 130 msec, were consistent with organic PSM.…”

Section: Resultsmentioning

confidence: 99%

Propriospinal myoclonus revisited

Roze

Bounolleau²,

Ducreux³

et al. 2009

Neurology

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The clinico-physiologic spectrum of propriospinal myoclonus (PSM) is homogenous. Involvement of the abdominal wall muscles, worsening in the lying position, premonitory sensation, and wake-sleep transition phase worsening are helpful clinical clues. Diffusion tensor imaging with fiber tracking appears more sensitive than conventional MRI for detecting associated microstructural abnormalities of the spinal cord. Symptomatic treatment of PSM is not straightforward, and clonazepam is reported to be the most effective drug. Zonisamide may be an interesting option.

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“…In einer retrospektiven Untersuchung bei 1124 Patienten mit der Verdachtsdiagnose einer nächtlichen Atmungsstörung fand sich bei 24% der Untersuchten ein PLMS-I >5/h, wobei der PLMS-I nicht mit der Ausprägung der Tagesmüdigkeit assoziiert war (Chervin et al 2001). Ein PLMS-I >5/h wurde bei 61% der untersuchten Patienten mit Syringomyelie (Nogues et al 2000), 48% der Patienten mit Sklerodermie (Prado et al 2002), 38% der Patienten mit Juveniler Fibromyalgie (Tayag-Kier et al 2000) festgestellt. Im Weiteren fanden sich erhöhte PLMS-I Werte bei Gilles-de-la-Tourette Syndrom (Voderholzer et al 1997), Rückenmarkläsionen (De Mello et al 2002), unbehandelten Parkinson-Patienten , Multisystematrophie und bei posttraumatischer Belastungsstörung (Brown u. Boudewyns 1996).…”

Section: Therapieunclassified

S3-Leitlinie

2009

Somnologie

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Periodic limb movements in syringomyelia and syringobulbia

Cited by 37 publications

References 17 publications

Sleep disorder: a possible cause of attention deficit in children and adolescents with Chiari malformation type II

Sleep disorder: a possible cause of attention deficit in children and adolescents with Chiari malformation type II

Propriospinal myoclonus revisited

S3-Leitlinie

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