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[睡眠与运动障碍]

[Sleep and movement disorders].

作者信息

Poryazova R, Bassetti C L

机构信息

Neurologische Klinik und Poliklinik, Universitätsspital Zürich.

出版信息

Ther Umsch. 2007 Jan;64(1):63-72. doi: 10.1024/0040-5930.64.1.63.

Abstract

The three different states of being (wakefulness, NREM and REM sleep) are associated with profound neurophysiological and neurochemical changes in the brain. These changes explain the existence of movement disorders appearing only or preferentially during sleep, and the effects of sleep on movement disorders. Sleep-related movement disorders are of clinical relevance for multiple reasons: 1) high frequency (e.g. restless legs syndrome (RLS)); 2) diagnostic relevance (e.g. REM sleep behavior disorder (RBD) as first manifestation of Parkinson disorder); 3) diagnostic uncertainty (e.g. parasomnias vs nocturnal epilepsy); 4) association with injuries (e.g. RBD, sleepwalking), sleep disruption/daytime sleepiness (e.g. RLS), and psycho-social burden (e.g. enuresis); 5) requirement of specific treatments (e.g. nocturnal epilepsy, stridor, RBD). This article gives an overview on clinical manifestations, pathophysiology, work-up and treatment of sleep-related movement disorders (e.g. RLS, bruxism), parasomnias (e.g. sleepwalking, RBD), sleep-related epilepsies, and on sleep-associated manifestations of movement disorders (e.g. Parkinson disease, multiple system atrophy).

摘要

三种不同的存在状态(清醒、非快速眼动睡眠和快速眼动睡眠)与大脑中深刻的神经生理和神经化学变化相关。这些变化解释了仅在睡眠期间或优先在睡眠期间出现的运动障碍的存在,以及睡眠对运动障碍的影响。与睡眠相关的运动障碍具有临床相关性,原因有多种:1)高发性(如不宁腿综合征(RLS));2)诊断相关性(如快速眼动睡眠行为障碍(RBD)作为帕金森病的首发表现);3)诊断不确定性(如梦游症与夜间癫痫);4)与损伤相关(如RBD、梦游)、睡眠中断/日间嗜睡(如RLS)以及心理社会负担(如遗尿症);5)需要特定治疗(如夜间癫痫、喘鸣、RBD)。本文概述了与睡眠相关的运动障碍(如RLS、磨牙症)、异态睡眠(如梦游、RBD)、与睡眠相关的癫痫以及运动障碍的睡眠相关表现(如帕金森病、多系统萎缩)的临床表现、病理生理学、检查和治疗。

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