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)

Animal data indicate that serotonin (5-HT) is a major neurotransmitter involved in the control of numerous central nervous system functions including mood, aggression, pain, anxiety, sleep, memory, eating behavior, addictive behavior, temperature control, endocrine regulation, and motor behavior. Moreover, there is evidence that abnormalities of 5-HT functions are related to the pathophysiology of diverse neurological conditions including Parkinson's disease, tardive dyskinesia, akathisia, dystonia, Huntington's disease, familial tremor, restless legs syndrome, myoclonus, Gilles de la Tourette's syndrome, multiple sclerosis, sleep disorders, and dementia. The psychiatric disorders of schizophrenia, mania, depression, aggressive and self-injurious behavior, obsessive compulsive disorder, seasonal affective disorder, substance abuse, hypersexuality, anxiety disorders, bulimia, childhood hyperactivity, and behavioral disorders in geriatric patients have been linked to impaired central 5-HT functions. Tryptophan, the natural amino acid precursor in 5-HT biosynthesis, increases 5-HT synthesis in the brain and, therefore, may stimulate 5-HT release and function. Since it is a natural constituent of the diet, tryptophan should have low toxicity and produce few side effects. Based on these advantages, dietary tryptophan supplementation has been used in the management of neuropsychiatric disorders with variable success. This review summarizes current clinical use of tryptophan supplementation in neuropsychiatric disorders.
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PMID:L-tryptophan in neuropsychiatric disorders: a review. 130 30

Several non-epileptic disorders may cause episodic and paroxysmal symptoms that resemble epilepsy and they must be considered in the differential diagnosis. Some of these disorders are discussed in the present review: vasovagal, vasomotor and cardiac syncopes, breath holding spells. Among the sleep disorders, parasomnias, nightmares and the benign neonatal sleep myoclonus are mentioned. Migraine with aura, alternating hemiplegia and benign vertigo of childhood are probably related disorders. Benign myoclonus of early infancy, paroxysmal choreoathetoses and pseudoepileptic or hysterical seizures are further non-epileptic attack disorders to be considered in the differential diagnosis.
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PMID:[Differential diagnosis of cerebral seizures]. 150 11

The elderly have more organic sleep problems disturbing sleep and contributing to insomnia than younger individuals. The most common disorders afflicting the elderly are obstructive sleep apnea, restless legs syndrome, and nocturnal myoclonus. Poor sleep habits often aggravate or contribute to the ongoing difficulty with sleeping. In the depressed elderly, characteristic EEG changes occur that may help distinguish major depression from pseudodementia; however, it should be considered that pseudodementia may be a harbinger of primary dementia. A careful sleep history and often evaluation by polysomnography are central to the management of sleep problems in the elderly. In conjunction with treatment of any underlying organic sleep disorders, brief administration of short-acting benzodiazepine sedatives for sleep onset insomnia or rapid-acting intermediate half-life benzodiazepines for sleep maintenance insomnia can be quite helpful in the elderly, especially if behavioral techniques also are employed. Elimination of medications, alcohol, and caffeine, which disturb sleep, is also an important part of the treatment approach.
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PMID:Sleep disorders in geriatric patients. 160 Apr 90

Forty-eight chronic hemodialysis (HD) patients (pts) completed questionnaires that used linear analogue scales (LAS), yes/no responses, and demographic data collection to characterize sleep disorders. Twenty-five pts (52%) reported problems sleeping. These pts graded sleep problems significantly higher than those without sleep problems (6.5 +/- 3 vs. 1.8 +/- 2, p less than 0.001 by LAS). Those with sleep disorders were more likely to smoke cigarettes (13/25 vs. 6/23, p less than 0.05) and have bone pain (14/25 vs. 6/23, p less than 0.05). No differences among pts with and without sleep problems were seen in age, gender, time on dialysis, caffeine intake, pruritus, feelings of sadness, worry, or anxiety, or Kt/V values (1.5 +/- 0.2 vs. 1.4 +/- 0.2, p less than 0.13). Restless legs (84%), onset insomnia (76%), and nighttime (76%) and early A.M. waking (72%) characterized the sleep disorders; symptoms suggesting nocturnal myoclonus were less common (20%). We conclude that sleep disorders are common in HD pts and may be exacerbated by tobacco use, bone pain, and restless legs. Kt/V does not correlate with sleep disorders. Further examination of this problem, including formal sleep studies, is needed.
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PMID:Characterizing sleep disorders in chronic hemodialysis patients. 175 Dec 35

Insomnia is one of the most common complaints encountered by the primary care physician. Yet, in many cases, physicians treat the symptom of insomnia rather than evaluating and treating the underlying causes of insomnia. Because the subjective complaint of insomnia does not always correlate with evidence of objective sleep disruption, a careful history and evaluation are required. Assessment of the duration of insomnia and quantification of the impact of nocturnal sleep disruption on daytime functioning provide the most reliable indices of severity. Primary insomnia may be due to a number of different causes, such as poor sleep hygiene or circadian rhythm disruption. Insomnia may also be the presenting symptom of other primary sleep disorders, such as sleep apnea syndrome or nocturnal myoclonus, or of a variety of medical or psychiatric illnesses. The treatment of the patient with insomnia should address the underlying cause, when identifiable. When the cause cannot be identified, treatment should be conservative; nonpharmacologic therapies should be used whenever possible. When pharmacologic approaches are indicated, short-acting benzodiazepines should be administered in concordance with strict prescribing guidelines. Frequent follow-up is necessary to ensure continued therapeutic efficacy of the prescribed therapy.
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PMID:Detection and assessment of insomnia. 179 May 41

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

The restless legs syndrome is generally benign but is occasionally associated with anemia, metabolic disorder, or polyneuropathy. Leg restlessness with disruptive nocturnal myoclonus has been described as a sleep disorder. We report two patients with complex partial and secondarily generalized seizures, who developed restless legs while taking methsuximide and phenytoin. They had no evidence of metabolic disturbance or neuromuscular disease, although one patient had fragmented sleep and disruptive myoclonus on polysomnography, and leg restlessness subsided with change of antiepileptic drugs. These symptoms could reflect transient alteration in peripheral nerve function not evident by examination or electrophysiologic studies, sleep disturbance by antiepileptic drugs or the effects of temporal lobe seizure foci on perception of the physiologic state of nerves and muscles.
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PMID:Restless legs with antiepileptic drug therapy. 314 64

Chronic musculoskeletal pain and fatigue of "fibrositis syndrome" are associated with a physiologic arousal disorder within sleep, the alpha (7.5 to 11 Hz) electroencephalographic, non-rapid-eye-movement sleep anomaly. In this nonrestorative sleep disorder, pain and mood symptoms may be mediated by psychologic distress (e.g., following a nonphysically injurious industrial or automobile accident), noxious environmental stimuli (e.g., noise), physiologic disturbance (e.g., sleep-related myoclonus, painful inflamed joints, i.e., rheumatoid arthritis), and altered central nervous system metabolism (e.g., disordered brain serotoninergic functions). Because such heterogeneous agents influence this hitherto poorly understood nonarticular rheumatic syndrome, the descriptive term "rheumatic pain modulation disorder" is suggested.
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PMID:Sleep and musculoskeletal pain. 346 14

Individuals 65 years of age and older were randomly selected, from a primarily white upper-class population, to participate in a study of sleep disorders in elderly adults. One hundred forty-five volunteers had a brief telephone interview, a home interview, and a portable sleep recording using the Medilog and Respitrace systems. By research classifications, we found that 18% of the elderly participants had sleep apnea (apnea index greater than 5), 34% had periodic movements in sleep (myoclonus index greater than 5) (PMS), and 10% had both sleep apnea and PMS. These were not clinical diagnoses. The home recording indicated that the individuals with PMS slept significantly less than other older adults.
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PMID:Sleep apnea and periodic movements in an aging sample. 400 77


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