DIBINEM - Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
IRCCS Istituto delle Scienze Neurologiche, AUSL di Bologna, Bologna, Italy.
J Clin Sleep Med. 2017 Nov 15;13(11):1355-1357. doi: 10.5664/jcsm.6816.
We report the case of a 14-year-old girl with a wide non-compressive pineal cyst, associated with the inability to control her sleep-wake schedule. Actigraphic monitoring showed a 24-hour free-running disorder (tau 26.96 hours). A 24-hour serum melatonin curve assay, with concomitant video-polysomnographic and body-core temperature monitoring, was performed. Melatonin curve showed a blunted nocturnal peak, lower total quantity of melatonin, and prolonged melatonin secretion in the morning, with normal temperature profile and sleep parameters. Treatment with melatonin up to 14 mg at bedtime was initiated with complete realignment of the sleep-wake rhythm (tau 23.93 hours). The role of the pineal cyst in the aforementioned alteration of melatonin secretion and free-running disorder remains controversial, but our case supports the utility of monitoring sleep/wake, temperature, and melatonin rhythms in the diagnostic work-up of pineal cysts associated with free-running disorder.
我们报告了一例 14 岁女孩患有广泛非压迫性的松果体囊肿，伴有无法控制其睡眠-觉醒节律的情况。活动记录仪监测显示存在 24 小时自由运行障碍（tau 值为 26.96 小时）。进行了 24 小时血清褪黑素曲线测定，同时进行视频多导睡眠图和体核温度监测。褪黑素曲线显示夜间峰值减弱，褪黑素总量减少，早晨褪黑素分泌延长，体温曲线和睡眠参数正常。睡前给予褪黑素 14mg 治疗后，睡眠-觉醒节律完全调整（tau 值为 23.93 小时）。松果体囊肿在上述褪黑素分泌和自由运行障碍改变中的作用仍存在争议，但我们的病例支持在诊断松果体囊肿相关自由运行障碍时监测睡眠/觉醒、温度和褪黑素节律的作用。
