Kawauchi A, Imada N, Tanaka Y, Minami M, Watanabe H, Shirakawa S
Department of Urology, Kyoto Prefectural University of Medicine, Japan.
Br J Urol. 1998 May;81 Suppl 3:72-5. doi: 10.1046/j.1464-410x.1998.00012.x.
To evaluate the mechanism of the dysfunction of arousal in patients with Type I and Type IIa enuresis.
The numbers of sleep spindles and delta waves were analysed during electroencephalography in 19 patients with enuresis (17 male, two female, mean age 9.7 years, range 8-14).
In four patients with Type I enuresis, who awoke spontaneously and remained dry as a result of urinary sensation, the numbers of sleep spindles and delta waves diminished gradually and finally disappeared just before the patients awoke completely. In the remaining nine patients with Type I enuresis, there was no decrease in the number of sleep spindles and delta waves, and enuresis occurred without the subjects awakening. In the six patients with Type IIa enuresis, there was no arousal reaction or generation of sleep spindles on urination while asleep.
An immaturity in the function of the thalamus might be a cause of the arousal dysfunction in patients with Type I enuresis. In Type IIa enuresis, a possible abnormal or immature arousal mechanism in the pons or the lower tract may be responsible.
评估Ⅰ型和Ⅱa型遗尿症患者觉醒功能障碍的机制。
对19例遗尿症患者（17例男性，2例女性，平均年龄9.7岁，范围8 - 14岁）进行脑电图检查，分析睡眠纺锤波和δ波的数量。
4例Ⅰ型遗尿症患者，能因尿意自发醒来且保持干爽，睡眠纺锤波和δ波数量逐渐减少，最终在患者完全醒来前消失。其余9例Ⅰ型遗尿症患者，睡眠纺锤波和δ波数量无减少，遗尿发生时患者未觉醒。6例Ⅱa型遗尿症患者，睡眠中排尿时无觉醒反应或睡眠纺锤波产生。
丘脑功能不成熟可能是Ⅰ型遗尿症患者觉醒功能障碍的原因。在Ⅱa型遗尿症中，脑桥或下尿路可能存在异常或不成熟的觉醒机制。
