Hu Gengyao, Yuan Na, Pan Yuanhang, Wang Bi, Wang Xiaoli, Wang Zezhi, Chen Ze, Liu Yonghong
Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China.
Department of Neurology, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, 710061, People's Republic of China.
Nat Sci Sleep. 2021 Dec 1;13:2113-2123. doi: 10.2147/NSS.S331893. eCollection 2021.
To evaluate clinical and electrophysiological features of sleep-related head jerk (SRHJ) and electromyographic activity of superficial neck muscles during head jerk.
Totally, 850 cases with video-polysomnography recording were collected, among which 50 presented with SRHJ. In these 50 patients, 15 underwent electromyography (EMG) check on bilateral sternocleidomastoid (SCM) and trapezius muscles as well as chin, while 35 had only chin EMG check. Further, the sensitivity and specificity of the both EMGs were calculated and compared.
Six among the 50 SRHJ patients had a primary complaint of involuntary head jerks associated with impaired sleep. Approximately 76.1% of head jerks occurred during REM sleep with the median head jerk index of 5.9/h, 64.5% of which were associated with electroencephalogram arousals and 66.4% with body movements. One patient showed SRHJ predominantly in NREM sleep but also in wakefulness. Surface EMG of SCM/trapezius muscles showed a sensitivity of 92% and a specificity of 97.8%, whereas chin EMG had a sensitivity of 14.5% and a specificity of 98.8%.
SRHJ was associated with electroencephalogram arousals and might interfere with sleep. Surface EMG of SCM/trapezius muscles exhibited a good accuracy in the revelation of SRHJ.
评估睡眠相关头部抽搐（SRHJ）的临床和电生理特征以及头部抽搐期间颈部浅表肌肉的肌电图活动。
共收集850例视频多导睡眠图记录病例，其中50例出现SRHJ。在这50例患者中，15例对双侧胸锁乳突肌（SCM）、斜方肌以及下巴进行了肌电图（EMG）检查，35例仅进行了下巴EMG检查。此外，计算并比较了两种EMG的敏感性和特异性。
50例SRHJ患者中有6例主要抱怨与睡眠受损相关的不自主头部抽搐。约76.1%的头部抽搐发生在快速眼动睡眠期，头部抽搐中位数指数为5.9次/小时，其中64.5%与脑电图觉醒相关，66.4%与身体运动相关。1例患者SRHJ主要出现在非快速眼动睡眠期，但在清醒时也出现。SCM/斜方肌的表面肌电图敏感性为92%，特异性为97.8%，而下巴肌电图敏感性为14.5%，特异性为98.8%。
SRHJ与脑电图觉醒相关，可能干扰睡眠。SCM/斜方肌的表面肌电图在揭示SRHJ方面表现出良好的准确性。
