Plazzi G, Corsini R, Provini F, Pierangeli G, Martinelli P, Montagna P, Lugaresi E, Cortelli P
Institute of Clinical Neurology, University of Bologna, Italy.
Neurology. 1997 Apr;48(4):1094-7. doi: 10.1212/wnl.48.4.1094.
We report the results of clinical and polysomnographic investigations on 39 consecutive multiple system atrophy (MSA) patients. Twenty-seven patients (69%) reported nocturnal motor paroxysmal episodes related to dreams, suggesting the clinical diagnosis of REM sleep behavior disorder (RBD). In 12 of them (44%), RBD preceded the clinical onset of the disease by more than 1 year. In seven (26%), the RBD onset was concomitant with and in eight (30%) was at least 2 years after the appearance of motor or autonomic symptoms. On polysomnographic recordings, 35 of 39 MSA patients (90%) had RBD. Other polysomnographic findings included nonclinical obstructive sleep apnea in 6 patients, laryngeal stridor in 8 patients, and periodic limb movements during sleep in 10 patients. Our data show that RBD represents the most common clinical sleep manifestation and polysomnographic finding in patients with MSA. RBD can frequently herald the appearance of other MSA symptoms by years. Extended polysomnographic montages are recommended in MSA sleep studies.
我们报告了对39例连续性多系统萎缩（MSA）患者进行临床和多导睡眠图检查的结果。27例患者（69%）报告有与梦境相关的夜间运动性发作，提示快速眼动睡眠行为障碍（RBD）的临床诊断。其中12例（44%），RBD在疾病临床发作前1年以上出现。7例（26%）中，RBD发作与运动或自主神经症状同时出现，8例（30%）中，RBD发作至少在运动或自主神经症状出现后2年。在多导睡眠图记录中，39例MSA患者中有35例（90%）存在RBD。其他多导睡眠图检查结果包括6例患者有非临床阻塞性睡眠呼吸暂停、8例患者有喉喘鸣以及10例患者在睡眠中有周期性肢体运动。我们的数据表明，RBD是MSA患者最常见的临床睡眠表现和多导睡眠图检查结果。RBD常常可在数年前预示其他MSA症状的出现。在MSA睡眠研究中建议采用扩展的多导睡眠图记录。
