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Agrypnia excitata.
MedLine Citation:
PMID:  23423537     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Agrypnia (from the Greek: to chase sleep) excitata (AE) is a syndrome characterized by loss of sleep and permanent motor and autonomic hyperactivation (excitata). Disruption of the sleep-wake rhythm consists in the disappearance of spindle-delta activities, and the persistence of stage 1 non-rapid eye movement (NREM) sleep. Rapid eye movement (REM) sleep persists but fails to stabilize, appearing in short recurrent episodes, isolated, or mixed with stage 1 NREM sleep. Diurnal and nocturnal motor, autonomic and hormonal overactivity is the second hallmark of AE. Of particular interest is the finding that norepinephrine secretion is extremely elevated at all hours of the day and night whereas the nocturnal melatonin peak is lacking. Oneiric stupor is probably an exclusive sign of AE and consists in the recurrence of stereotyped gestures mimicking simple daily life activities. Agrypnia excitata aptly defines 3 different clinical conditions, fatal familial insomnia (FFI), an autosomal dominant prion disease, Morvan syndrome (MS), an autoimmune encephalitis, and delirium tremens (DT), the alcohol withdrawal syndrome. Agrypnia excitata is due to an intralimbic disconnection releasing the hypothalamus and brainstem reticular formation from cortico-limbic inhibitory control. This pathogenetic mechanism is visceral thalamus degeneration in FI, whereas it may depend on autoantibodies blocking voltage-gated potassium (VGK) channels within the limbic system in MS, and in the sudden changes in gabaergic synapses down-regulated by chronic alcohol abuse within the limbic system in DT.
Authors:
Federica Provini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current neurology and neuroscience reports     Volume:  13     ISSN:  1534-6293     ISO Abbreviation:  Curr Neurol Neurosci Rep     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-02-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100931790     Medline TA:  Curr Neurol Neurosci Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  341     Citation Subset:  IM    
Affiliation:
IRCCS Istituto delle Scienze Neurologiche di Bologna and Department of BioMedical and NeuroMotor Sciences University of Bologna, Bellaria Hospital, Via Altura, 3, Bologna, Italy, federica.provini@unibo.it.
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