Sleep-arousal dissociation in a case of hypersomnia
Introduction. Dissociated sleep-arousal states are clinical and experimental phenomena which represent mixed forms of the three stages of this cycle (arousal, NREM sleep and REM sleep). Clinical case. We describe the case of a man who presented with a history of excessive diurnal somnolence for the previous 5 years. He also had symptoms of sleep paralysis, hypnagogic hallucinations, automatic behavior and excessive movements during sleep. He had had no episodes of loss of muscle tone; MR was normal; HL DR2 and DQw1 antigens were negative; two polisomnographic and a Multiple Latency Sleep test showed: 1. Absence of respiratory disorders. 2. Normal latency of REM sleep. 3. Periods of dissociated sleep (REM without atonia and arousal with atonia), and 4. An average sleep latency of 3.2 minutes and absence of REM periods. Conclusion. This case adds a new type of dissociated sleep state which may accompany the disorder known as hypersomnia without REM periods
Caso clínico Se describe el caso de un varón que presenta una historia de excesiva somnolencia diurna de cinco años de evolución. Como síntomas asociados relata parálisis de sueño, alucinaciones hipnagógicas, conducta automática y excesivos movimientos durante el sueño. No refiere episodios de pérdida de tono muscular; RMN normal; antígenos HL DR2 y DQw1 negativos. Dos estudios polisomnográficos y un test de latencias múltiples de sueño destacaron: 1. Ausencia de trastornos respiratorios; 2. Latencia de sueño REM normal; 3. Períodos de sueño disociado (REM sin atonía y vigilia con atonía), y 4. Una latencia media de sueño de 3,2 minutos de duración y ausencia de períodos REM.
Conclusión Este caso añade un nuevo tipo de estado disociado de sueño que puede acompañar al trastorno denominado hipersomnia sin períodos
