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Cascais I, Ashworth J, Ribeiro L, Freitas J, Rios M. A rare case of tongue biting during sleep in childhood. J Clin Sleep Med 2024; 20:653-656. [PMID: 38152859 PMCID: PMC10985298 DOI: 10.5664/jcsm.10966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
Bleeding tongue-biting episodes during sleep are a rare and alarming situation that can negatively impact the child's and parents' sleep, affecting their quality of life. Although highly suggestive of epilepsy, a differential diagnosis should be made with sleep-related movement disorders such as bruxism, hypnic myoclonus, facio-mandibular myoclonus, and geniospasm when this hypothesis is excluded. The clinical history, electroencephalogram, and video-polysomnography are essential for diagnostic assessment. Treatment with clonazepam can be necessary in the presence of frequent tongue biting that causes severe injuries and sleep disturbance. This study reports the challenging case of managing and diagnosing a 2-year-old boy with recurrent tongue biting during sleep since he was 12 months old, causing bleeding lacerations, frequent awakenings, and significant sleep impairment with daytime consequences for him and his family. CITATION Cascais I, Ashworth J, Ribeiro L, Freitas J, Rios M. A rare case of tongue biting during sleep in childhood. J Clin Sleep Med. 2024;20(4):653-656.
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Affiliation(s)
- Inês Cascais
- Department of Pediatrics, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António (CMIN-CHUdSA), Porto, Portugal
| | - Joanna Ashworth
- Department of Pediatrics, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António (CMIN-CHUdSA), Porto, Portugal
| | - Lúcia Ribeiro
- Department of Neurophysiology, CMIN-CHUdSA, Porto, Portugal
| | - Joel Freitas
- Department of Neurophysiology, CMIN-CHUdSA, Porto, Portugal
| | - Marta Rios
- Department of Pediatrics, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António (CMIN-CHUdSA), Porto, Portugal
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Thomas DC, Manfredini D, Patel J, George A, Chanamolu B, Pitchumani PK, Sangalli L. Sleep bruxism: The past, the present, and the future-evolution of a concept. J Am Dent Assoc 2024; 155:329-343. [PMID: 38363252 DOI: 10.1016/j.adaj.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND The concept of sleep bruxism (SB) has evolved exponentially over the past several decades. Many theories and hypotheses have been proposed as to the definition, pathophysiology, and management of SB, from the early 1960s through the present. The role of peripheral factors, such as dental occlusion, in the pathogenesis of SB has been discarded. TYPES OF STUDIES REVIEWED The authors searched several electronic databases (ie, PubMed, Google Scholar, Web of Science, Embase, and Ovid MEDLINE) for studies on bruxism. The search was conducted from January 1961 through May 2023 and yielded 4,612 articles, of which 312 were selected for comprehensive review after eliminating duplicates and nonfocused articles. RESULTS There has been an evident progressive shift from the role of peripheral factors, such as dental occlusion, to more central factors, such as the involvement of a central pattern generator as well as the autonomic nervous system, in the genesis of bruxing movements. There is continued robust interest in the dental community to elucidate the contributing factors involved in SB. CONCLUSIONS AND PRACTICAL IMPLICATIONS The neurophysiology of SB appears to be leaning more toward central rather than peripheral factors. There is increasing evidence of the role of the autonomic nervous system, genetics, and comorbidities in the genesis of SB. The scientific literature seems to refute the role of dental occlusion in the causation of bruxing movements. As per the literature, there has been a paradigm shift in the definition and genesis of SB and its possible dental implications and management, which also highlights the need for succinct scientific studies in this regard.
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Hu G, Pan Y, Yuan N, Yang Z, Shi X, Ma S, Li S, Hou X, Liu F, Li D, Bao J, Liu Y. Tongue Biting Event in Patients with Sleep-Related Facial Mandibular Myoclonus: A Case Series Study. Nat Sci Sleep 2024; 16:207-215. [PMID: 38410526 PMCID: PMC10895986 DOI: 10.2147/nss.s433628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/28/2023] [Indexed: 02/28/2024] Open
Abstract
Background Sleep-related facial mandibular myoclonus (SRFMM) remains rare in clinical practice. The aim of this study was to provide a comprehensive understanding of the electroclinical manner, therapeutic regimen, and prognosis of SRFMM. Methods Twenty-three patients who were diagnosed with SRFMM by clinical manifestation, video-electroencephalography (EEG) and electromyography over bilateral masseter and temporalis muscles were enrolled. Clinical and electrophysiological evaluation as well as follow-up information were recorded and analyzed. Results The cohort involved 4 infants and 19 adults with a mean onset age of 43.5 years for SRFMM, among whom 19 were male. Twenty-one patients complained of tongue injuries and disturbed night-time sleep. SRFMM in 4 patients were ascribed to oral aripiprazole, brainstem ischemia and brain trauma. In 62 SRFMM episodes, 93.5% occurred in NREM sleep and 6.5% in REM sleep, and all events were associated with EEG arousals. In 13 patients with or without clonazepam, the motor events gradually disappeared, and the rest turned to be sporadic. Conclusion SRFMM is a characteristic parasomnia manifested by tongue biting and accompanying facial mandibular myoclonus, leading to disrupted sleep. Besides adults, infants can also experience SRFMM with spontaneous remission. Most patients respond well to clonazepam, eventually with favorable prognosis.
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Affiliation(s)
- Gengyao Hu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China
| | - Yuanhang Pan
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China
| | - Na Yuan
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China
| | - Zhixian Yang
- Department of Pediatrics, Peking University First Hospital, Beijing, People’s Republic of China
| | - Xiuyu Shi
- Department of Pediatrics, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China
| | - Sha Ma
- Department of Neurology, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China
| | - Shan Li
- Department of Neurology, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, People’s Republic of China
| | - Xiaohua Hou
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Fei Liu
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Dongmei Li
- Department of Dentistry for Special Services, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China
| | - Junxiang Bao
- Department of Aerospace Hygiene, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China
| | - Yonghong Liu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi’an, People’s Republic of China
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Klitynska OV, Martyts YM, Gurando VR, Layoch NV. Effectiveness of bruxism treatment in young adults. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:417-423. [PMID: 38691781 DOI: 10.36740/wlek202403107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Aim: This study aimed to assess the effectiveness of the developed algorithm for treatment and prevention measures aimed at eliminating clinical manifestations of bruxism in young people. PATIENTS AND METHODS Materials and Methods: A cohort of 377 individuals aged 25 to 44 years underwent examination. Based on identified etiological factors, three distinct groups were delineated. Treatment and preventive strategies were then implemented and evaluated. Tailored treatment algorithms were devised for each group: Group one received selective grinding of supracontacts (up to 0.5-0.75 mm) and treatment for orthodontic issues utilizing removable and fixed orthodontic structures. Group two underwent finger self-massage of masticatory muscles, fabrication of biting dental splints, and anti-inflammatory drug therapy. Group three received sedative drug therapy in conjunction with psychiatric consultation, based on indications. Treatment efficacy was assessed 12 months post-initiation. Statistical analyses were conducted using Statistica 10.0 (StatSoft, Inc., USA) and Microsoft Office Excel 2010. RESULTS Results: In cases where orthodontic pathology and supracontacts predominated (r=0.99, p<0.05), employing selective grinding and orthodontic treatment according to specific indications yielded significant efficacy. This approach resulted in a notable reduction in bruxism severity, corroborated by occludogram results 12 months post-treatment initiation. Notably, 90.0% of occludogram indicators fell within the 90-100% range, accompanied by a decrease in the BruxChecker abrasion facets area (p<0.05). Further, there was a substantial enhancement in occlusal contacts (Ck=0.68, Ck =0.71, Ck =0.93). In instances where TMJ pathology predominated with high reliability (r=0.98, p<0.05), effective normalization of masticatory muscle tone and alleviation of temporomandibular joint issues were observed. After 12 months, palpation revealed minimal tenderness in specific muscle areas and normalization of electromyography readings from initial indicators (p<0.05). Moreover, when the psycho-emotional factor primarily contributed to bruxism etiology (r=0.97, p<0.05), medical intervention proved effective. This approach led to bruxism disappearance and normalization of the psycho-emotional state within 12 months (p<0.05). CONCLUSION Conclusions: The conducted studies provide high-confidence evidence of the effectiveness of bruxism treatment when diagnosing the prevailing etiological factor and targeting its specific impact, leading to the normalization of all other factors, a reduction in bruxism intensity, and its complete disappearance.
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Affiliation(s)
| | - Yurii M Martyts
- TERNOPIL NATIONAL MEDICAL UNIVERSITY NAMED AFTER I.YA. GORBACHEVSKIY, TERNOPIL, UKRAINE
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Zhang S, Aung T, Lv Z, Zhao X, Wang P, Shi T, Guo S, Geng Y, Jin B. Epilepsy imitator: tongue biting caused by sleep-related facio-mandibular myoclonus. Seizure 2020; 81:186-191. [DOI: 10.1016/j.seizure.2020.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/22/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022] Open
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Wang X, Yuan N, Wang B, Liu Y. Characteristics of nocturnal facio-mandibular myoclonus in four middle-aged patients. Sleep Med 2020; 68:24-26. [PMID: 32018188 DOI: 10.1016/j.sleep.2019.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/08/2019] [Accepted: 09/03/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Xiaoli Wang
- Epilepsy and Sleep Disorders Unit, Department of Neurology, Xijng Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Na Yuan
- Epilepsy and Sleep Disorders Unit, Department of Neurology, Xijng Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Bi Wang
- Epilepsy and Sleep Disorders Unit, Department of Neurology, Xijng Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Yonghong Liu
- Epilepsy and Sleep Disorders Unit, Department of Neurology, Xijng Hospital, The Fourth Military Medical University, Xi'an, 710032, China.
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Tongue biting resulting from sleep-related facio-mandibular myoclonus as a cause for misdiagnosed epilepsy. Acta Neurol Belg 2017; 117:787-788. [PMID: 28161792 DOI: 10.1007/s13760-017-0753-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 01/23/2017] [Indexed: 10/20/2022]
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Arima S, Sato S, Tsuchimochi T, Nakayama M. A case of involuntary rhythmic and characteristic tapping sounds during sleep. Sleep Med 2017; 36:35-37. [PMID: 28735918 DOI: 10.1016/j.sleep.2017.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 04/11/2017] [Accepted: 04/28/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Sachie Arima
- Department of Otorhinolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Good Sleep Center, Nagoya City University Hospital, Nagoya, Japan
| | - Shintaro Sato
- Department of Otorhinolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Good Sleep Center, Nagoya City University Hospital, Nagoya, Japan
| | - Tsukasa Tsuchimochi
- Department of Otorhinolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Department of Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Meiho Nakayama
- Department of Otorhinolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Good Sleep Center, Nagoya City University Hospital, Nagoya, Japan.
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Chowdhury T, Bindu B, Singh GP, Schaller B. Sleep Disorders: Is the Trigemino-Cardiac Reflex a Missing Link? Front Neurol 2017; 8:63. [PMID: 28289401 PMCID: PMC5326750 DOI: 10.3389/fneur.2017.00063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/13/2017] [Indexed: 12/26/2022] Open
Abstract
Trigeminal innervated areas in face, nasolacrimal, and nasal mucosa can produce a wide array of cardiorespiratory manifestations that include apnea, bradypnea, bradycardia, hypotension, and arrhythmias. This reflex is a well-known entity called "trigemino-cardiac reflex" (TCR). The role of TCR is investigated in various pathophysiological conditions especially in neurosurgical, but also skull base surgery procedures. Additionally, its significance in various sleep-related disorders has also been highlighted recently. Though, the role of diving reflex, a subtype of TCR, has been extensively investigated in sudden infant death syndrome. The data related to other sleep disorders including obstructive sleep apnea, bruxism is very limited and thus, this mini review aims to investigate the possible role and correlation of TCR in causing such sleep abnormalities.
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Affiliation(s)
- Tumul Chowdhury
- Department of Anesthesiology and Perioperative Medicine, University of Manitoba , Winnipeg, MB , Canada
| | - Barkha Bindu
- Department of Neuro-anaesthesiology and Critical Care, All India Institute of Medical Sciences , New Delhi , India
| | - Gyaninder Pal Singh
- Department of Neuro-anaesthesiology and Critical Care, All India Institute of Medical Sciences , New Delhi , India
| | - Bernhard Schaller
- Department of Research, University of Southampton , Southampton , UK
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Abe S, Gagnon JF, Montplaisir JY, Postuma RB, Rompré PH, Huynh NT, Kato T, Kawano F, Lavigne GJ. Sleep bruxism and oromandibular myoclonus in rapid eye movement sleep behavior disorder: a preliminary report. Sleep Med 2013; 14:1024-30. [DOI: 10.1016/j.sleep.2013.04.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 03/20/2013] [Accepted: 04/30/2013] [Indexed: 12/01/2022]
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Tassinari CA, Gardella E, Cantalupo G, Rubboli G. Relationship of Central Pattern Generators with Parasomnias and Sleep-Related Epileptic Seizures. Sleep Med Clin 2012. [DOI: 10.1016/j.jsmc.2012.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Several movement disorders may occur during nocturnal rest disrupting sleep. A part of these complaints is characterized by relatively simple, non-purposeful and usually stereotyped movements. The last version of the International Classification of Sleep Disorders includes these clinical conditions (i.e. restless legs syndrome, periodic limb movement disorder, sleep-related leg cramps, sleep-related bruxism and sleep-related rhythmic movement disorder) under the category entitled sleep-related movement disorders. Moreover, apparently physiological movements (e.g. alternating leg muscle activation and excessive hypnic fragmentary myoclonus) can show a high frequency and severity impairing sleep quality. Clinical and, in specific cases, neurophysiological assessments are required to detect the presence of nocturnal movement complaints. Patients reporting poor sleep due to these abnormal movements should undergo non-pharmacological or pharmacological treatments.
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Tassinari C, Cantalupo G, Högl B, Cortelli P, Tassi L, Francione S, Nobili L, Meletti S, Rubboli G, Gardella E. Neuroethological approach to frontolimbic epileptic seizures and parasomnias: The same central pattern generators for the same behaviours. Rev Neurol (Paris) 2009; 165:762-8. [DOI: 10.1016/j.neurol.2009.08.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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DUTRA KMC, PEREIRA JR FJ, ROMPRÉ PH, HUYNH N, FLEMING N, LAVIGNE GJ. Oro-facial activities in sleep bruxism patients and in normal subjects: a controlled polygraphic and audio-video study. J Oral Rehabil 2009; 36:86-92. [DOI: 10.1111/j.1365-2842.2008.01912.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Dylgjeri S, Pincherle A, Ciano C, Binelli S, Villani F. Sleep-related tongue biting may not be a sign of epilepsy: a case of sleep-related faciomandibular myoclonus. Epilepsia 2009; 50:157-9. [PMID: 19125838 DOI: 10.1111/j.1528-1167.2008.01760.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wehrle R, Bartels A, Wetter TC. Facio-mandibular myoclonus specific during REM sleep. Sleep Med 2009; 10:149-51. [DOI: 10.1016/j.sleep.2008.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Revised: 12/29/2007] [Accepted: 01/21/2008] [Indexed: 11/17/2022]
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Loi D, Provini F, Vetrugno R, D'Angelo R, Zaniboni A, Montagna P. Sleep-related faciomandibular myoclonus: A sleep-related movement disorder different from bruxism. Mov Disord 2007; 22:1819-22. [PMID: 17657812 DOI: 10.1002/mds.21661] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We describe a 33-year-old man who presented with lip and tongue nibbling and bleeding during sleep. Videopolysomnography revealed myoclonic jerks involving the masticatory and facial muscles recurring mainly during NREM sleep. There was no tonic EMG masticatory activity typical of bruxism. EMG analysis demonstrated the recruitment of V- to VII innervated muscles and, in half of the episodes, also the sternocleidomastoideus. Our patient had sleep-related faciomandibular myoclonus (SFMM) with spontaneous jerks of oromasticatory and cervical muscles, occurring only during sleep. Tooth grinding, temporomandibular joint pain, abnormal tooth mobility, tooth wear, and other dental problems were clinically absent. We propose that, on the basis of the clinical and EMG features, SFMM may be considered a distinct disorder and different from sleep bruxism.
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Affiliation(s)
- Daniela Loi
- Department of Neurological Sciences, University of Cagliari, Cagliari, Italy
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22
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Tinuper P, Provini F, Bisulli F, Vignatelli L, Plazzi G, Vetrugno R, Montagna P, Lugaresi E. Movement disorders in sleep: guidelines for differentiating epileptic from non-epileptic motor phenomena arising from sleep. Sleep Med Rev 2007; 11:255-67. [PMID: 17379548 DOI: 10.1016/j.smrv.2007.01.001] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Seizures, namely in certain epileptic conditions, may be precipitated by sleep. Nocturnal frontal lobe epilepsy seizures, characterized by bizarre motor behaviour and autonomic activation, appear almost exclusively during sleep. The differential diagnosis between this condition and sleep-related non-epileptic paroxysmal motor phenomena, in particular the parasomnias, is arduous. Moreover, accepted criteria for the diagnosis of nocturnal frontal lobe seizures are lacking and even ictal scalp EEG recording could fail to disclose paroxysmal abnormalities. The clinical and polygraphic features of the different types of seizures in nocturnal frontal lobe epilepsy and of the more common non-epileptic paroxysmal events during sleep are described. The main differentiating features characterizing nocturnal frontal seizures are: onset at any age, several attacks per night at any time during the night, brief duration (s) with stereotyped motor pattern. As video-polysomnographic recordings of the attack, the gold-standard for diagnosis, are expensive and not readily available everywhere, home-made video recordings may be helpful. Further investigations on pathophysiology, genetics and epidemiology are needed to clarify the relationship between epileptic and non-epileptic sleep related paroxysmal phenomena.
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Affiliation(s)
- Paolo Tinuper
- Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy.
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Lee IK. Non-epileptic paroxysmal events during sleep - Differentiation from epileptic seizures -. KOREAN JOURNAL OF PEDIATRICS 2007. [DOI: 10.3345/kjp.2007.50.8.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- In Kyu Lee
- Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Korea
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Derry CP, Duncan JS, Berkovic SF. Paroxysmal Motor Disorders of Sleep: The Clinical Spectrum and Differentiation from Epilepsy. Epilepsia 2006; 47:1775-91. [PMID: 17116016 DOI: 10.1111/j.1528-1167.2006.00631.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The diagnosis of paroxysmal events in sleep represents a significant challenge for the clinician, with the distinction of nocturnal epilepsy from nonepileptic sleep disorders often the primary concern. Diagnostic error or uncertainty is not uncommon in this situation, particularly with respect to nocturnal frontal lobe epilepsy (NFLE), which has a variable and often unusual presentation. Such errors can be minimized if the range of nonepileptic disorders with motor activity in sleep is fully appreciated. Here we review these disorders, before discussing the important clinical and electrographic features that allow their accurate differentiation from seizures. Particular emphasis is placed on the differentiation of nocturnal frontal lobe epilepsy from non-rapid eye movement (NREM) arousal disorders and other parasomnias. The value of recording episodes with video EEG polysomnography is discussed.
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Affiliation(s)
- Christopher P Derry
- Epilepsy Research Centre and Department of Medicine (Neurology), University of Melbourne, Australia.
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Abstract
Parasomnias are unpleasant or undesirable behavioral or experiential phenomena that occur during sleep. Once believed unitary phenomena related to psychiatric disorders, it is now clear that parasomnias result from several different phenomena and usually are not related to psychiatric conditions. Parasomnias are categorized as primary (disorders of the sleep states) and secondary (disorders of other organ systems that manifest themselves during sleep). Primary sleep parasomnias can be classified according to the sleep state of origin: rapid eye movement sleep, non-rapid eye movement sleep, and miscellaneous (those not respecting sleep state). Secondary sleep parasomnias are classified by the organ system involved.
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Affiliation(s)
- Mark W Mahowald
- Minnesota Regional Sleep Disorders Center, Minneapolis, MN 55415, USA.
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Della Marca G, Rubino M, Vollono C, Vasta I, Scarano E, Mariotti P, Cianfoni A, Mennuni GF, Tonali P, Zampino G. Rhythmic tongue movements during sleep: A peculiar parasomnia in Costello syndrome. Mov Disord 2005; 21:473-8. [PMID: 16250029 DOI: 10.1002/mds.20741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We describe a peculiar parasomnia observed in four Costello infants, characterized by periodic rhythmic movements of the tongue. Ten Costello patients (4 male; age range 9 months to 29 years) underwent 1 full-night laboratory-based video polysomnography. The four youngest patients (2 male and 2 female; age range 9-31 months) presented during sleep repeated stereotyped movements of the tongue, producing a sucking-like or licking-like movement, mostly during non-rapid eye movement (NREM) sleep. Rhythmic tongue movements in Costello syndrome show the features of an NREM sleep parasomnia. Tongue movements during sleep probably originate from brainstem structures and could be facilitated by an impaired control of the oropharyngeal and tongue muscles.
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Affiliation(s)
- Giacomo Della Marca
- Unit of Sleep Medicine, Department of Neuroscience, Catholic University, Rome, Italy.
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