Montagna P, Provini F, Plazzi G, Liguori R, Lugaresi E
Institute of Clinical Neurology, University of Bologna, Italy.
Mov Disord. 1997 Jan;12(1):66-72. doi: 10.1002/mds.870120112.
Three patients, aged 71, 50, and 41 years, presented with myoclonic activity arising in the relaxation period preceding sleep onset and causing severe insomnia. Polygraphic studies showed that the myoclonic activity began in spinally innervated muscles, propagating at low speed to rostral and caudal muscular segments. Myoclonus arose whenever patients relaxed mentally and showed diffuse electroencephalographic alpha activity and was independent of posture. The jerks disappeared during sleep. Clonazepam afforded symptomatic improvement. Propriospinal myoclonus arising from a spinal generator may be facilitated by changes in supraspinal control related to vigilance levels. When arising during relaxation and drowsiness, it may cause severe insomnia.
三名患者，年龄分别为71岁、50岁和41岁，表现为在入睡前期的放松期出现肌阵挛活动，并导致严重失眠。多导睡眠图研究显示，肌阵挛活动始于脊髓支配的肌肉，以低速向头侧和尾侧肌肉节段传播。每当患者精神放松并出现弥漫性脑电图α活动时就会出现肌阵挛，且与姿势无关。这些抽搐在睡眠期间消失。氯硝西泮可使症状改善。源自脊髓发生器的脊髓性肌阵挛可能因与警觉水平相关的脊髓上控制变化而加重。当在放松和困倦期间出现时，可能会导致严重失眠。
