Pathological REM sleep

Introduction The disease is characterized by irresistible short-term sleep. The disease is an unclear syndrome characterized by abnormal sleep tendency, including excessive sleepiness during the day, nighttime sleep disturbance and pathological REM sleep. More than children or adolescent onset, men and women with similar incidence rates may have a history of encephalitis or craniocerebral trauma. The pathogenesis of this disease is not clear, and may be related to the lowering of the function of the ascending activation system of the brainstem network or the reticular nucleus hyperfunction of the caudal brain. Most patients with other symptoms such as cataplexy, sleep paralysis, sleep hallucinations, etc. Sleeping quadruple syndrome.

Cause

Episodes of sleeping sickness are sleep disorders characterized by paroxysmal irresistible sleep during the day. The prevalence of the disease reported in foreign countries is about 0.2-0.9%, and there is no significant difference in the prevalence of male and female. Most cases start after the age of 10, and about 5% of the cases occur before the age of 10. The disease is closely related to the DQB1 allele HLA-DQB1*0102. The specific cause is unknown and may be related to genetic factors and abnormal sleep mechanisms.

an examination

Polysomnography shows a shortened sleep latency

Diagnose based on:

According to the transient episode of irresistible sleep or typical symptoms such as stumbling, sleep paralysis, sleep hallucinations, the general diagnosis is not difficult. However, it must be identified with the following diseases.

First, epileptic seizures. More common in children or adolescents, with disturbance of consciousness as the main symptom, often sudden loss of consciousness, eye-opening, standing still, not falling; or suddenly ending the ongoing action, such as holding the object, can not continue the original action, It lasts for a few seconds. The electroencephalogram can have a 3 Hz spine-slow integrated wave.

Second, fainted. A transient transient loss of consciousness due to cerebral blood circulation disorders. There are many short signs of dizziness, weakness, nausea, blackness in front of the eyes, and then fainted after loss of consciousness. Often accompanied by autonomic symptoms, such as pale, cold sweat, weak pulse, lower blood pressure, lasting for a few minutes.

Third, Kleine-Levin syndrome. Also known as periodic sleepiness and pathological hunger syndrome. Usually seen in male juveniles, with periodic episodes (intervals or weeks), each lasting 3 to 10 days, manifested as lethargy, bulimia and behavioral abnormalities. The etiology and pathogenesis are still unclear, and may be caused by dysfunction of the diencephalon, especially the hypothalamus or focal encephalitis.

Auxiliary inspection:

1. EEG.

2, cerebrospinal fluid cell examination.

3. CT and brain biopsy.

Differential diagnosis

Sleep rhythm disorder: is a regular disorder of sleep caused by diseases such as circadian rhythm sleep disorders and sleep-wake rhythm disorders. Physiological rhythm disorder sleep disorder: persistent or repeated disturbances lead to excessive sleep or insomnia, which is due to the patient's 24-hour sleep-awakening rhythm pattern and the rhythm required by his or her environment. Sleep-wake rhythm disorder refers to the sleep-wake rhythm and the required discrepancy, resulting in persistent dissatisfaction with the quality of sleep. Patients have anxiety or fear, and cause mental activity to decline and impede social function. This disease is not part of any physical illness or mental disorder. If sleep-wake rhythm disorder is an integral part of a physical illness or a mental disorder (such as depression), it is not diagnosed as a sleep-wake rhythm disorder.

Deep sleep disorder: The posterior hypothalamic lesion can cause deep sleep: sleep for several days or weeks, in the middle can be woken up to eat or go to the bathroom, and then sleep again. The hypothalamus weighs about 4g and is small in size. In function, the hypothalamus is the center of neuroendocrine and autonomic regulation of the body. On the whole, the hypothalamus is both a nerve center and an endocrine organ, and is a hub for the nervous system to control the interconnection between endocrine and endocrine organs and internal and external receptors. At least 11 species of secretory hormones have been identified in hypothalamic neurons.

Sleep disorders: abnormal sleep and the appearance of abnormal behavior during sleep. It is also a manifestation of normal rhythmic disorder of sleep and wakefulness.

Sleep paralysis: When a person suddenly dreams of awakening, a part of the nerve center of the brain has awakened, but the nerve center that dominates the muscle has not fully awoke, so although there is an uncomfortable feeling, it is impossible to move.

Diagnose based on:

According to the transient episode of irresistible sleep or typical symptoms such as stumbling, sleep paralysis, sleep hallucinations, the general diagnosis is not difficult. However, it must be identified with the following diseases.

First, epileptic seizures. More common in children or adolescents, with disturbance of consciousness as the main symptom, often sudden loss of consciousness, eye-opening, standing still, not falling; or suddenly ending the ongoing action, such as holding the object, can not continue the original action, It lasts for a few seconds. The electroencephalogram can have a 3 Hz spine-slow integrated wave.

Second, fainted. A transient transient loss of consciousness due to cerebral blood circulation disorders. There are many short signs of dizziness, weakness, nausea, blackness in front of the eyes, and then fainted after loss of consciousness. Often accompanied by autonomic symptoms, such as pale, cold sweat, weak pulse, lower blood pressure, lasting for a few minutes. Third, Kleine-Levin syndrome. Also known as periodic sleepiness and pathological hunger syndrome. Usually seen in male juveniles, with periodic episodes (intervals or weeks), each lasting 3 to 10 days, manifested as lethargy, bulimia and behavioral abnormalities. The etiology and pathogenesis are still unclear, and may be caused by dysfunction of the diencephalon, especially the hypothalamus or focal encephalitis.

Auxiliary inspection:

1. EEG.

2, cerebrospinal fluid cell examination.

3. CT and brain biopsy.

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