Bruno R L
The Post-Polio Institute at Englewood Hospital and Medical Center, New Jersey 07631, USA.
Am J Phys Med Rehabil. 1998 Jul-Aug;77(4):339-43. doi: 10.1097/00002060-199807000-00015.
Nearly two-thirds of polio survivors report abnormal movements in sleep, with 52% reporting that their sleep is disturbed by these movements. Sleep studies were performed in seven polio survivors to document objectively abnormal movements in sleep. Two patients demonstrated generalized random myoclonus, with brief contractions and even ballistic movements of the arms and legs, slow repeated grasping movements of the hands, slow flexion of the arms, and contraction of the shoulder and pectoral muscles. Two other patients demonstrated periodic movements in sleep with muscle contractions and ballistic movements of the legs, two had periodic movements in sleep plus restless legs syndrome, and one had sleep starts involving only contraction of the arm muscles. Abnormal movements in sleep occurred in Stage II sleep in all patients, in Stage I in some patients, and could significantly disturb sleep architecture even though patients were totally unaware of muscle contractions. Poliovirus-induced damage to the spinal cord and brain is presented as a possible cause of abnormal movements in sleep. The diagnosis of post-polio fatigue, evaluation of abnormal movements in sleep, and management of abnormal movements in sleep using benzodiazepines or dopamimetic agents are described.
近三分之二的脊髓灰质炎幸存者报告称睡眠中有异常动作，其中52%的人表示这些动作干扰了他们的睡眠。对7名脊髓灰质炎幸存者进行了睡眠研究，以客观记录睡眠中的异常动作。两名患者表现出全身性随机肌阵挛，伴有手臂和腿部的短暂收缩甚至弹道式动作、手部缓慢重复的抓握动作、手臂缓慢屈曲以及肩部和胸肌收缩。另外两名患者表现出睡眠期周期性动作，伴有腿部肌肉收缩和弹道式动作，两名患者有睡眠期周期性动作加不安腿综合征，一名患者有仅涉及手臂肌肉收缩的睡眠惊跳。所有患者的睡眠异常动作均出现在睡眠二期，部分患者出现在睡眠一期，即使患者完全没有意识到肌肉收缩，这些动作也会显著干扰睡眠结构。脊髓灰质炎病毒对脊髓和大脑的损伤被认为是睡眠异常动作的一个可能原因。文中描述了脊髓灰质炎后疲劳的诊断、睡眠异常动作的评估以及使用苯二氮䓬类药物或多巴胺能药物对睡眠异常动作的管理。
