Horita H, Hoashi E, Okuyama Y, Kumagai K, Endo S
Folia Psychiatr Neurol Jpn. 1977;31(3):393-402. doi: 10.1111/j.1440-1819.1977.tb02626.x.
We observed the attacks of nystagmus in a case of infantile spasms and carried out overnight sleep polygraphy. The following findings were obtained: (1) Awake time was prolonged to 56% of TIB, while sleep time was markedly shortened to 44% of TIB. Also REM sleep time was reduced to 20% of SPT and deep slow sleep (stage N3) was absent. (2) Attacks of nystagmus were observed only during wakefulness. At first, fast wave bursts appeared in the right occipital area, and were followed by left-upward deviations of eyeballs, and then the attacks of counterclockwise right-downward rotatory nystagmus. Also the fast wave bursts were succeeded by spreading of fast waves to adjacent areas. At the same time, EMG exhibited elevated muscle action potentials of mentalis and biceps femoris. During the attacks of nystagmus, there was alteration of respiratory movements. In NREM sleep, both fast wave bursts and the attacks of nystagmus were not observed. In REM sleep, the fast wave bursts and eye movements were observed but the attacks of nystagmus did not appear. During the fast wave bursts, alteration of respiratory movements were observed. From the results of this study, it was presumed that the brain lesions of this case were extended with severe degree of damage in the great parts of brain containing cerebral cortex and brain stem.
我们观察了一例婴儿痉挛症患者的眼球震颤发作情况，并进行了夜间睡眠多导记录。获得了以下结果：(1) 清醒时间延长至总卧床时间（TIB）的56%，而睡眠时间显著缩短至TIB的44%。快速眼动（REM）睡眠时间也减少至总睡眠时间（SPT）的20%，且无深度慢波睡眠（N3期）。(2) 仅在清醒期间观察到眼球震颤发作。起初，右枕叶区域出现快波爆发，随后眼球向左上方偏斜，接着出现逆时针向右下方旋转性眼球震颤发作。快波爆发后，快波还会扩散至相邻区域。同时，肌电图显示颏肌和股二头肌的肌肉动作电位升高。在眼球震颤发作期间，呼吸运动发生改变。在非快速眼动（NREM）睡眠中，未观察到快波爆发和眼球震颤发作。在REM睡眠中，观察到快波爆发和眼球运动，但未出现眼球震颤发作。在快波爆发期间，观察到呼吸运动改变。根据本研究结果，推测该病例的脑损伤范围扩大，大脑包括大脑皮层和脑干的大部分区域受损程度严重。
