Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027066 (myoclonus)
 4,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Symptoms of excessive daytime somnolence range from mild to severe. In mild cases, there may be minimal interference with normal daytime function. The hypersomnia can be disabling. When severe the patient finds it difficult to remain awake at times when physically inactive. Excessive daytime somnolence is the chief complaint of the majority of our adult patients. In this paper, we present the findings for 1,000 consecutive patients (755 males and 245 females) who were seen at the Humana Hospital Audubon Sleep Disorders Center. Patients ranged in age from 15 to 83. All patients had a sleep history, medical history and physical, psychological evaluation, polysomnographic evaluation, and other laboratory tests as indicated. Obstructive sleep apnea syndrome was the most prevalent diagnosis for males (84.2%) and females (59.6%). It accounted for over three-fourths of all diagnoses. Hypersomnia secondary to a psychiatric disorder was the next most frequent diagnosis overall (6.1%). A psychiatric disorder was second for females and third for males. Narcolepsy was diagnosed for 5.8% of all patients. This was the second most prevalent diagnosis for males and third for females. Eighteen males (47.4% of all males with a diagnosis of narcolepsy) and 9 females (45.0%) had cataplexy. Nocturnal myoclonus was the primary diagnosis in 2.5% of all patients with excessive daytime somnolence. An additional 49 patients with sleep apnea syndrome and 18 patients with narcolepsy also had periodic leg movements during sleep. A diagnosis of obstructive sleep apnea and narcolepsy was made for 1.3% of patients. The narcolepsy component of this diagnosis was typically made only after the obstructive sleep apnea had been resolved (eg, nasal CPAP, tracheostomy).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Disorder of excessive daytime somnolence: a case series of 1,000 patients. 239 10

We report 38 consecutive patients referred to a sleep disorder clinic who on diagnostic polysomnography showed excessive amounts of brief fragmentary myoclonus throughout all stages of NREM sleep. Almost all patients were male despite a reasonably equal sex distribution of referral. The phenomenon was found associated with sleep-related respiratory problems, periodic movements in sleep (PMS), narcolepsy, intermittent hypersomnia and (rarely) insomnia. It also occurred associated with excessive daytime sleepiness (EDS) as an isolated polysomnographic finding apart from some degree of sleep fragmentation.
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PMID:Excessive fragmentary myoclonus in NREM sleep: a report of 38 cases. 241 Feb 21

"Muscle activity in the legs (MAL)" is an extension of the classification, nocturnal myoclonus, to include all phasic muscle activity in the legs during sleep, irrespective of the repetitiveness, periodicity, or minimum duration of the muscle events. This report examined the number of MAL events and, especially, MAL events associated with arousals (MAL arousals) and awakenings (MAL awakenings) in the clinical records of 9 narcoleptics, 42 obstructive sleep apnea (OSA) patients, and 12 nocturnal myoclonus patients. The mean MAL arousals/hr for narcoleptics, OSA patients, and nocturnal myoclonus patients were 20.5, 3.0, and 12.9, respectively; the mean MAL awakenings/hr were 2.5, 0.2, and 1.3, respectively. Both the narcoleptics and nocturnal myoclonus patients had significantly more MAL arousals/hr and MAL awakenings/hr of sleep than OSA patients. Nonetheless, 62% of the OSA patients had greater than or equal to 1 MAL arousal/hr. Narcoleptics had significantly more MAL awakenings/hr than nocturnal myoclonus patients; narcoleptics also had more MAL arousals/hr of sleep than nocturnal myoclonus patients, but this difference was not significant. Most, 89%, of the narcoleptics, 22% of the OSA patients, and 100% of the nocturnal myoclonus patients had greater than or equal to 5 MAL arousals/hr of sleep. These findings suggest that there may be a relationship between the pathogenesis of MAL, narcolepsy, and OSA.
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PMID:Muscle activity in the legs (MAL) associated with frequent arousals in narcoleptics, nocturnal myoclonus and obstructive sleep apnea (OSA) patients. 379 45

A 42-year-old patient is reported who presented with marked daytime sleepiness and in whom the only major nocturnal polysomnographic abnormality was intense fragmentary (partial) myoclonus occurring with equal frequency in all stages of NREM sleep associated with some degree of sleep fragmentation. The myoclonus was very brief (less than 150 msec duration), aperiodic and recurred in asynchronous and asymmetrical fashion over the legs, arms and face. It appears unrelated to the clinically similar physiological myoclonus of REM sleep. Other main sleep disorders such as periodic movements, restless leg syndrome, sleep apnea and narcolepsy-cataplexy were excluded by history and polysomnography.
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PMID:Fragmentary pathological myoclonus in NREM sleep. 620 Feb 93

Disturbed nocturnal sleep is considered a symptom of narcolepsy. Polysomnographic recordings of 57 consecutive narcoleptic patients were reviewed for evidence of disturbed sleep. When disrupted sleep was present, it was attributable to recognized sleep disorders: nocturnal myoclonus and sleep apnea. Comparison of standard polysomnographically derived parameters of patients who had narcolepsy without sleep apnea or nocturnal myoclonus with those of a normal control group, showed no evidence of disturbed sleep in the patient population. The narcoleptics that also had nocturnal myoclonus or upper airway sleep apnea did have disturbed sleep in comparison with the normals. Our data suggest disturbed sleep tends to develop in narcolpetic patients with age, but is not an inherent element of the narcolepsy syndrome.
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PMID:Narcolepsy and disturbed nocturnal sleep. 661 86

The advances in research on sleep an biological rhythms have recently been applied to the diagnosis and treatment of sleep disorders. A new clinical specialty has developed with the establishment of sleep disorder centers and a diagnostic classification of sleep and arousal disorders. This new nosological approach has evolved from an extensive base of new scientific information concerning descriptive polygraphic and analysis of clinical case series. Four major categories have been defined: (a) disorders of initiating and maintaining sleep (insomnias), (b) disorders of excessive somnolence, (c) disorders of the sleep-wake schedule, and (d) dysfunctions associated with sleep. Within this comprehensive classification certain major pathophysiological advances are described for the "insomnias." These include polysomnographic identification of altered sleep stage patterns in the major effective illnesses, insomnias related to hypnotic drugs and alcohol, sleep disturbances associated with sleep-induced respiratory impairment, and sleep-related periodic movements during sleep (nocturnal myoclonus). Excessive daytime somnolence is primarily associated with the hypersomnia sleep-apnea syndrome and with narcolepsy. The relationship between biological rhythms (chronobiology) and disorders of the human sleep-wake schedules is very actively investigated. The recognition that sleep length, internal organization, and timing within neurophysiological circadian time-keeping systems has lead to better diagnosis of these sleep-wake disorders and new chronotherapeutic regimens. Finally, increasing identification and description of "parasomnias," i.e. dysfunctions associated with sleep, has led sleep research into important new areas that are of general physiological interest. It is now clear that sleep disorders medicine has become a new scientific and clinical discipline in its own right.
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PMID:Sleep and its disorders. 701 38

The Sleep Disorders Clinic at the San Diego Veterans Administration Medical Center provides a diagnostic service within a public hospital. Case records of the first 117 patients receiving polysomnograms in our clinic were reviewed. Of these patients, 44 percent were found to have sleep apnea, 24 percent nocturnal myoclonus and 8 percent narcolepsy. Our experience shows that in a health maintenance organization, a sleep disorders clinic provides diagnostic information (based on a polysomnogram and a sleep history) which is very helpful in the final diagnosis of medical disorders. Very few recordings were noncontributory. In this setting, a sleep disorders clinic is justified by its rich diagnostic yield.
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PMID:Benefits of a sleep disorders clinic in a Veterans Administration Medical Center. 725 75

A man who showed excessive twitch movement, such as fragmentary myoclonus (FM) and periodic movements in sleep (PMS) predominantly during REM sleep, is reported. He complained of excessive daytime sleepiness (EDS). After examination, his twitch movements were shown not to accompany narcolepsy, and his EDS were considered to originate from nocturnal sleep disturbance caused by FM and PMS.
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PMID:Excessive twitch movements in rapid eye movement sleep with daytime sleepiness. 947 25

The prevalence of sleep-related disorders (SRD) in adults in Turkey is unknown. The main objective of our study was to assess the prevalence of SRD in Sivas, Turkey. Adults living in Sivas, a city of Turkey from the central region of Anatolia at 20-107 years of age, in both genders, of the 5339 persons, who attended the survey 2638 (49.4%) were male and 2701 (50.6%) were female. The prevalence of insomnia, habitual snoring, obstructive sleep apnea (OSA) and day time hyper somnolence was 40.3%, 37.0%, 6.4%, 24.0% respectively. The prevalence rates of narcolepsy and nocturnal myoclonus was 30.6%, 40.1% respectively. There was a statistical significance between the persons of above 60 years old and another age groups (p< 0.05). But we did not find any significant difference between smokers and non-smokers, also between males and females about SRD prevalence (p> 0.05). However, sleep apnea prevalence was about 9 times higher in the persons suffering from hypertension than without hypertension. Also sleep apnea prevalence was 12 times higher in the persons suffering from overweight. This study has shown that sleep-disordered breathing (SDB) prevalence in Turkey is as high as in other countries and may be more common.
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PMID:The prevalence of sleep related disorders in Sivas, Turkey. 1700 51

Differential diagnosis between epileptic and nonepileptic paroxysmal disorders is fundamental not only to allow correct management of patients but also to avoid the burden of unnecessary antiepileptic medication. The focus of this chapter is limited to imitators of idiopathic generalized epilepsies (IGE) which are expressed through myoclonic, tonic-clonic, tonic, atonic, and absence seizures. Apparent losses of consciousness and drop attacks also have to be considered. Benign myoclonus of early infancy is the main nonepileptic disorder in the differential diagnosis of infantile spasms, but is not dealt with here because West syndrome is not an IGE. Hyperekplexia, metabolic disorders, hypnagogic myoclonus, and disturbed responsiveness caused by the use of drugs are listed in Table 1. Other conditions that may imitate more focal epileptic seizures are omitted. Benign neonatal sleep myoclonus, apnea and apparent life-threatening events in infants, cyanotic and pallid breath-holding spells, syncope, staring spells, psychogenic seizures, hyperventilation syndrome, and narcolepsy have been selected based on frequency or difficulties in differential diagnosis with the intention to cover the most conspicuous imitators of IGE in different ages.
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PMID:Nonepileptic disorders imitating generalized idiopathic epilepsies. 1630 79


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