The term Charcot Wilbrand syndrome (CWS) denotes dream loss following focal b rain damage. We report the first case of CWS, in whom neuropsychological functio ns, extension of the underlying lesion, and sleep architec...The term Charcot Wilbrand syndrome (CWS) denotes dream loss following focal b rain damage. We report the first case of CWS, in whom neuropsychological functio ns, extension of the underlying lesion, and sleep architecture changes were asse ssed. A 73 year old woman reported a total dream loss after acute, bilateral o ccipital artery infarction (including the right inferior lingual gyrus), which l asted for over 3 months. In the absence of sleep wake complaints and (other) ne uropsychological deficits, polysomnography demonstrated an essentially normal sl eep architecture with preservation of REM sleep. Dreaming was denied also after repeated awakenings from REM sleep. This observation suggests that CWS (1) can r epresent a distinct and isolated neuropsychological manifestation of deep occipi tal lobe damage, and (2) may occur in the absence of detectable REM sleep abnorm alities.展开更多
Cerebrospinal fluid (CSF) hypocretin-1 deficiency is associated with definite (“clear cut”) cataplexy in patients with narcolepsy. The relationship between CSF hypocretin-1 levels and other narcoleptic symptoms (inc...Cerebrospinal fluid (CSF) hypocretin-1 deficiency is associated with definite (“clear cut”) cataplexy in patients with narcolepsy. The relationship between CSF hypocretin-1 levels and other narcoleptic symptoms (including excessive daytime sleepiness, EDS) is not properly understood. In a consecutive series of 18 subjects with narcolepsy and definite cataplexy, patients with undetectable CSF hypocretin-1 (n = 12) were found to have significantly lower mean sleep latencies (p = 0.045) and a higher frequency of sleep onset REM periods (SOREMPs, p = 0.025) on multiple sleep latency test than patients (n = 6) with detectable levels. Conversely, Epworth sleepiness scale scores, the frequency of hallucinations /sleep paralysis, and the frequency and severity of cataplexy were similar in both groups. These results suggest that hypocretin deficiency identifies a homogenous group of patients with narcolepsy characterised by the presence of definite cataplexy, severe EDS, and frequent SOREMPs.展开更多
文摘The term Charcot Wilbrand syndrome (CWS) denotes dream loss following focal b rain damage. We report the first case of CWS, in whom neuropsychological functio ns, extension of the underlying lesion, and sleep architecture changes were asse ssed. A 73 year old woman reported a total dream loss after acute, bilateral o ccipital artery infarction (including the right inferior lingual gyrus), which l asted for over 3 months. In the absence of sleep wake complaints and (other) ne uropsychological deficits, polysomnography demonstrated an essentially normal sl eep architecture with preservation of REM sleep. Dreaming was denied also after repeated awakenings from REM sleep. This observation suggests that CWS (1) can r epresent a distinct and isolated neuropsychological manifestation of deep occipi tal lobe damage, and (2) may occur in the absence of detectable REM sleep abnorm alities.
文摘Cerebrospinal fluid (CSF) hypocretin-1 deficiency is associated with definite (“clear cut”) cataplexy in patients with narcolepsy. The relationship between CSF hypocretin-1 levels and other narcoleptic symptoms (including excessive daytime sleepiness, EDS) is not properly understood. In a consecutive series of 18 subjects with narcolepsy and definite cataplexy, patients with undetectable CSF hypocretin-1 (n = 12) were found to have significantly lower mean sleep latencies (p = 0.045) and a higher frequency of sleep onset REM periods (SOREMPs, p = 0.025) on multiple sleep latency test than patients (n = 6) with detectable levels. Conversely, Epworth sleepiness scale scores, the frequency of hallucinations /sleep paralysis, and the frequency and severity of cataplexy were similar in both groups. These results suggest that hypocretin deficiency identifies a homogenous group of patients with narcolepsy characterised by the presence of definite cataplexy, severe EDS, and frequent SOREMPs.
