Clinical and polysomnographical investigations have been performed in 35 patients with REM narcolepsy (group 1), comparatively with 45 patients suffering from symptomatic hypersomnia in NREM sleep (group 2). The polysomnographical recordings have been made by: a) continuous recording covering 24 h; b) submission of the subjects to the "Maintenance of wakefulness tests" (MWT). In 20 narcoleptics and in 12 normal subjects, computerized EEG mappings were performed in wakefulness and in different sleep stages. In the narcoleptic patients, the association of the sleep attacks with other symptoms of Gélineau's disease has been noticed. The 24 h continuous polysomnographical recordings pointed out relevant differences between the first and the second group: the patients with REM narcolepsy (Gélineau's disease) presented increased quantities and percentages of REM sleep and manifested several periods wish sleep-onset REM. Comparatively, the patients with NREM hypersomnias slept predominantly in NREM sleep, and presented normal percentages of REM sleep and also manifested sleep-onset NREM periods. One found great differences between the two groups by the MWT, that is, in the first group the mean values of REM sleep were greater, the REM latency and the sleep latency were very short and one assisted to many sleep-onset REM. The cortical EEG mappings were ampler and slower on the right posterior temporal and occipital regions (especially during the REM sleep) either in normal or in narcoleptic patients. These results suggest the consistency of some previous data regarding the differentiation of the true REM narcolepsy (as an independent entity) from the various frequent NREM hypersomnias.

Adult↗

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Electroclinical correlations in temporal lobe epilepsy.

2,698 epileptic patients were studied, 2,019 cases (64.3%) presenting temporal lobe epileptic attacks. Besides the routine EEG recordings and the corroboration of the clinical data with the meticulous observations by video monitoring on a closed circuit TV-screen (the patients being observe in a specially arranged room, provided with infra-red cameras), the diagnostic procedure was supported in all cases by several computerized EEG mappings, according to a model achieved by us, transcribing the primary data obtained by Hjorth's NSD parameters from the Siemens-Elema Mingograph to a Romanian M-118 microprocessor. In many cases we utilized an interface--built by us--for analog-digital conversion which allowed the direct introduction and conversion of amplitudes and frequencies from the Mingograph to the micro-computer. These were isolated to analyse the following electroclinical forms: 1. temporal absences: 360 cases (17.8%); 2. psychomotor attacks: 439 cases (21.7%) 3. psychosensory attacks: 77 cases (3.8%); 4. attacks with cognitive symptomatology: 260 cases (12.8%); 5. crises with ideative-affective symptomatology: 76 cases (3.8%); 6. vegetative attacks: 51 cases (2.5%); 7. akinetic attacks: 89 cases (4.4%); 8. focal temporal attacks secondarily generalized: 667 cases (33.0%). In 112 patients with nocturnal attacks, polysomnographic recordings were performed with sequential computerized EEG mappings during the various stages of sleep (concomitantly with the infrared video-TV monitoring).

Adult↗

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Clinical, computerized EEG and polysomnographical studies in some myoclonic syndromes.

Forty-two patients with myoclonic manifestations (especially during subacute sclerosing panencephalitis (SSPE)) were studied. The multidimensional investigations pointed out that myoclonias produce several EEG and polysomnographical perturbations: 1. Sleep disorganization; 2. Appearance of the myoclonic jerks in wakefulness (especially) and in some sleep stages; 3. Some electroclinical discordances; 4. A great variability of the myoclonias during some sleep stages; 5. EEG cortical mappings showed individual variabilities of Radermecker complexes.

Brain Mapping↗

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Polysomnographical researches in patients with temporal lobe epilepsy.

One hundred and twelve patients with temporal lobe epilepsy were studied. Continuous polysomnographical recordings were performed for eight hours, the patients being video-monitored all the time. These researches, completed with computerized EEG cortical mappings demonstrated a peculiar activation of the temporal foci during REM phases and during some stages of LSWS.

Brain Mapping↗

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Polygraphic patterns of sleep in various age groups of normal children.

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Age Factors↗

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Relationships between the degree and topography of the atherosclerotic lesions of the extracranial carotid axis with the clinical form of ischaemic attack, evaluated by duplex methodology.

Carotid echotomography (CET) in the duplex system was made in 118 patients with atherosclerotic lesions of various degree (insignificant stenoses--ISS; significant stenoses--SS and thromboses) of the extracranial carotid axis. The atherosclerotic lesions were localized mainly at the level of the carotid bifurcation (CB) and/or at the level of the carotid sinus. The clinical form of the ischaemic attack was better correlated with the extension of atherosclerotic lesions in the extracranial carotid axis than with the severity of these lesions.

Blood Flow Velocity↗

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Lipoproteinlipase activity in multiple sclerosis and other neurologic diseases.

Taking into account the disturbances of lipid metabolism occurring in patients with demyelinating diseases, an expected finding was their increased basal lipolytic activity. We investigated 135 cases divided into 4 categories: 1. MS; 2. inflammatory diseases of the CNS; 3. cerebrovascular diseases and other diseases without any CNS organic involvements; 4. a group of absolutely healthy controls (blood donors). High values of plasmatic lipolytic activity were found in multiple sclerosis patients as compared with the other groups. They were probably due to the effect of a disturbance with an influence upon the basal lipoproteinlipase activity too. This influence is likely to refer to the stages of the process by which heparin releases lipoprotein-lipase from the capillary endothelium. Significant correlations between the clinical evolution of the disease and the values of lipolytic activity were pointed out. Measurement of this activity is a useful biochemical test in the diagnosis of multiple sclerosis.

Adult↗

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Parasomnias (non-epileptic nocturnal episodic manifestations) in patients with magnesium deficiency.

Twenty seven patients with parasomnias (night terrors, nocturnal motor automatisms, nocturnal verbal automatisms and sometimes with bruxisms) associated with magnesium deficiency were selected. In all of them marked hypomagnesemia, clinical, EEG and EMG signs of spasmophilic syndromes were found. The 8 hours polysomnographical recordings of all cases (monitored in a system with infra-red video-TV cameras) showed severe sleep disorders and EEG nocturnal abnormalities occurring in the SWS (especially in the I b, II and III stages) with disappearance in the REM sleep. The authors suggest that these clinical and polysomnographic anomalies may be the expression of the brain damage caused by magnesium deficiency or of the clinical electrographic manifestations of the reticulate neuronal hypersynchrony exacerbated by sleep.

Adolescent↗

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Spectral analysis of Doppler signal in the prophylaxis of ischemic cerebrovascular accidents in extra- and/or intracranial carotid and vertebral systems.

Using continuous-wave spectral analysis of Doppler signal (SADS) and/or pulsed-wave transcranial Doppler ultrasonography (TCD-US) we examined 263 patients with ischemic cerebrovascular diseases (ICVD) symptoms in the carotid and vertebrobasilar (V-B) systems. The degree of stenosis was established by taking into consideration the parameters of the spectrum of frequency (systolic peak velocity--SV; end-diastolic velocity--DV); the ratio between SV of internal carotid artery (ICA) and common carotid artery (CCA); the ratio between DV of ICA and CCA as well as the value of the spectral broadening (SB) index. The diminution of DV in CCA with increased values of Pourcelot's circulatory resistance index (RP) and spectral broadening index (SB) as compared with the controlateral part, but with apparent increase (over 3.5 kHz) of SV in ICA was constantly observed in significant stenoses of extracranial ICA. Our observations have pointed out that when proximal ICA occlusion is being formed slowly and progressively, ECA (whose increased circulatory resistance under normal conditions reflects diminished diastolic velocities) gradually takes over the hemodynamic characteristics of ICA which is expressed by increased DV, approximating DV and ICA. This situation may give rise to erroneous interpretations.

Blood Flow Velocity↗

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REM sleep dependent release of vasotocin into cerebrospinal fluid of narcoleptics.

The lumbar cerebrospinal fluid (CSF) collected from 6 narcoleptic patients (three males and three females) aged between 31 and 47 years, as well as from 2 patients having Pickwickian syndromes with hypersomnia attacks (two males), aged 43-51 years, contained relatively high amounts of arginine vasotocin (AVT) only if the CSF was removed after a REM sleep period. The release was not induced by darkness since the same release of AVT occurred when the CSF was removed after a REM sleep period during daylight hours. No detectable AVT levels have been found in the CSF samples of four narcoleptics collected after a NREM period of sleep, either during night or daylight hours. The present results suggest a possible alteration of the rhythmical release of AVT both in narcolepsy and in narcoleptic syndromes.

Adult↗

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Pineal vasotocin: REM sleep dependent release into cerebrospinal fluid of man.

Lumbar cerebrospinal fluid (CSF) of seven healthy male volunteers contains detectable levels of arginine vasotocin (AVT) when CSF was removed after awakening from rapid eye movement (REM) sleep. No detectable levels of AVT were found in the CSF of the same subjects when CSF WAS removed after awakening from non rapid eye movement (NREM) sleep. The amount of AVT detected in CSF after REM sleep was significantly higher if the subjects experienced vivid and emotive dreams. The present results provide the first evidence for a REM sleep dependent release of AVT into CSF of man.

Adult↗

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[Nocturnal bruxism. Contributions to the detection and assessment of involvement in the craniomandibular pain dysfunction syndrome].

The authors review the most updated information concerning the etiopathogenesis of nocturnal bruxism, stressing the co. destructive role of psychosomatic factors and of traumatogenic ones, of the type of premature dental contacts, and of occluding interferences, with evident direct implications in the buccal cavity and at a distance, giving rise to hypnic masticatory automatism, with painful hypercontraction of the masticatory muscles, and stress exerted on the temporomandibular articulations. On the basis of original studies of the interdisciplinary type (prosthetic gnathology and neurophysiology), with the aid of polygraphic investigations during sleep carried out in subjects with nocturnal bruxism it was possible to demonstrate that this oral parafunction may determine sleep disturbances at a central level which makes necessary a complex stomatologic and neuropsychiatric medical therapy.

Bruxism↗