Cyclic alternating pattern as a provocative factor in nocturnal paroxysmal dystonia.

Abstract

PURPOSE:

We made a polygraphic study of 6 patients with nocturnal paroxysmal dystonia (NPD) in which the cyclic alternating pattern (CAP) parameters were compared with those of a group of age- and sex-matched controls.

METHODS:

All patients met the requirements for NPD diagnosis, characterized by generalized stereotyped movements (dystonic-dyskinetic), with a 1-min centered duration but with no clear evidence of epileptic abnormalities in the waking EEG and during nocturnal recordings.

RESULTS:

Besides the major events, the NPD polysomnograms also showed shorter, repeated episodes of shorter duration (generally <20 s) consisting of abrupt movements involving one or more body segments. Overall, the motor events in patients with NPD were closely related to periods of unstable non-REM (NREM) sleep, as evidenced by the sequences of CAP, and began during an A phase. According to the conventional scoring parameters, NPD and controls differed only in sleep latency (+14 min in the NPD patients: p < 0.04). However, the architecture of sleep in the group with NPD was characterized by prolonged and irregular NREM/REM cycles. In addition, the NPD recordings showed significantly higher values of CAP rate (p < 0.0001). When major motor attacks were suppressed by medication, sleep was characterized by a decrease in the excessive amounts of CAP rate and by a more regular architecture.

CONCLUSIONS:

The modulatory role of CAP on nocturnal motor events is reported.

• Authors: M G Terzano, M F Monge-Strauss, F Mikol, M C Spaggiari, L Parrino
• Journal: Epilepsia (Epilepsia) Vol. 38 Issue 9 Pg. 1015-25 (Sep 1997) ISSN: 0013-9580 [Print] United States
• PMID: 9579941 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Dystonia (diagnosis, physiopathology)
• Electroencephalography
• Female
• Humans
• Male
• Middle Aged
• Motor Activity (physiology)
• Movement Disorders (diagnosis, physiopathology)
• Periodicity
• Polysomnography (statistics & numerical data)
• Sleep Stages (physiology)
• Sleep Wake Disorders (diagnosis, physiopathology)
• Stereotypic Movement Disorder (diagnosis, physiopathology)