Document Detail

Repetitive sleep starts in neurologically impaired children: an unusual non-epileptic manifestation in otherwise epileptic subjects.
MedLine Citation:
PMID:  10937135     Owner:  NLM     Status:  MEDLINE    
Sleep starts, also called hypnagogic or hypnic jerks, are bilateral, sometimes asymmetric, usually single, brief body jerks that coincide with sleep onset. We describe sleep starts occurring repetitively in three epileptic children with spastic-dystonic diplegia and mental retardation. Repetitive sleep starts began at age 18 months in two children and at 9 months in the third. All three children had had feto-neonatal asphyxia; two presented with spastic and one with dystonic tetraparesis. One had West syndrome and two had partial motor seizures in the first year of life. Seizures were controlled in all three patients by antiepileptic drug therapy. Video/EEG recordings of all the children during the afternoon nap revealed clusters of sleep starts during the transition between wakefulness and sleep. Cluster lasted 4-15 min and comprised from twenty to twenty-nine contractions. The EEG counterpart of the event sometimes showed an arousal response, at times inducing complete awakening. Repetitive sleep starts should be recognized and clearly differentiated from epileptic seizures, especially if they appear in epileptic subjects. In neurologically compromised patients, they could represent an intensification of an otherwise normal event, due to the lack of strong inhibitory influence of the pyramidal tract resulting from the pyramidal lesion.
L Fusco; C Pachatz; R Cusmai; F Vigevano
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Epileptic disorders : international epilepsy journal with videotape     Volume:  1     ISSN:  1294-9361     ISO Abbreviation:  Epileptic Disord     Publication Date:  1999 Mar 
Date Detail:
Created Date:  2000-09-07     Completed Date:  2000-09-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100891853     Medline TA:  Epileptic Disord     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  63-7     Citation Subset:  IM    
Division of Neurology, Bambino Gesu' Children's Hospital IRCCS, Rome, Italy.
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MeSH Terms
Cerebral Cortex / physiopathology
Cerebral Palsy / diagnosis*,  physiopathology
Child, Preschool
Epilepsies, Partial / diagnosis,  physiopathology
Epilepsy / diagnosis*,  physiopathology
Epilepsy, Partial, Motor / diagnosis,  physiopathology
Mental Retardation / diagnosis*,  physiopathology
Pyramidal Tracts / physiopathology
Sleep Stages / physiology
Sleep-Wake Transition Disorders / diagnosis*,  physiopathology
Spasms, Infantile / diagnosis,  physiopathology
Wakefulness / physiology

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