Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Italy.
Neurosurgery Unit, Neuroscience Department, Anna Meyer Pediatric Hospital, University of Florence, Florence, Italy.
J Clin Sleep Med. 2017 Dec 15;13(12):1477-1481. doi: 10.5664/jcsm.6854.
Disorders of consciousness may follow brain injury, due to impairments of wakefulness and/or awareness. Polysomnography can identify elements that may be ascribed to impairments of specific neuroanatomical areas. Recognizing which impairments affect each patient is crucial for diagnosis, prognosis, and to select an appropriate therapy. We present a pediatric case of insufficient wakefulness in a patient with severe disability following a pilocytic astrocytoma. Polysomnography was crucial for diagnosis, as it detected a well-structured pattern with daytime sleep initiations in the REM sleep phase. Treatment with modafinil was successful, as confirmed by polysomnography, leading to partial recovery of the patient's consciousness and communication ability. We suggest that polysomnography is a useful diagnostic tool to direct the pharmacotherapy and rehabilitation of states of reduced consciousness.
意识障碍可能继发于脑损伤，是由于觉醒和/或意识受损所致。多导睡眠图可以识别可能归因于特定神经解剖区域损伤的因素。识别哪些损伤影响每个患者对于诊断、预后和选择适当的治疗至关重要。我们报告了一例儿童病例，患者患有严重残疾，继发于毛细胞星形细胞瘤，存在觉醒不足。多导睡眠图对于诊断至关重要，因为它检测到一种具有 REM 睡眠阶段日间睡眠起始的结构良好的模式。莫达非尼治疗是成功的，多导睡眠图证实了这一点，这导致患者的意识和沟通能力部分恢复。我们建议多导睡眠图是一种有用的诊断工具，可以指导意识降低状态的药物治疗和康复。
