睡眠相关的节律性运动障碍的临床特点  

Clinical study of sleep related rhythmic movement disorder

作　　者：白洁[1] 马铁[1] 张文娟[1] 陈蓓蓓[1] 袁娜[1] 吴中亮[1] 刘永红[1] 

机构地区：[1]第四军医大学西京医院神经内科脑电监测中心,西安710032

出　　处：《中华神经科杂志》2016年第3期243-246,共4页Chinese Journal of Neurology

摘　　要：目的探讨睡眠相关的节律性运动障碍（SRMD）的临床及电生理特点。方法对本院脑电监测中心收治的3例SRMD患者的临床和电生理特点进行研究。3例患者均符合第三版国际睡眠障碍分类中推荐的SRMD的诊断标准，并且随访时间均在1年以上。结果3例患者均为男性，年龄6—27岁。1例13岁起病，持续至今；另2例均1岁起病，1例7岁后自行缓解，另一例2岁好转，21岁复发。3例患者的视频脑电图发作期均未见痫样放电，发作时同步肌电变化曾被误认为是脑电的慢波活动。视频多导睡眠图显示：全夜觉醒次数和微觉醒指数较高。2例使用氯硝西泮治疗，1例效果显著，1例效果不佳，加用盐酸曲唑酮后疗效显著。结论SRMD不仅发生于婴幼儿时期，亦可见于青少年和成年。对于影响睡眠质量的患者有必要给予治疗，氯硝西泮可明显减轻症状及改善睡眠质量，对于服用氯硝西泮效果不佳者，可以尝试加用盐酸曲唑酮。正确地监测和解读视频脑电图对发作性疾病的诊断非常重要。Objective To discuss the clinical and electrophysiological characteristics of sleep related rhythmic movement disorder （SRMD）. Methods We studied the clinical and electrophysiological characteristics of 3 patients diagnosed as SRMD in the Electroencephalography Monitoring Center of Xijing Hospital, Xi＇ an, China. The 3 patients accorded with diagnostic criteria of SRMD that international classification of sleep disorders-3 edition recommended and were followed up for more than 1 year. Results These 3 male patients were ranging from 6 to 27 years old. The onset age of the patient 1 was 13 years,and the others were 1 year old. The patient 2 became symptom-free at the age of 7. The patient 3 relieved at 2- year-old, but recurred at the age of 21. There was no epileptic seizure discharge in video- electroencephalography of the 3 patients, but synchronous electromyography changes during the attack were mistaken for slow wave. Video-polysomnography showed that numbers of awakenings and arousals index were high. Two patients were treated with clonazepam. One had an obvious curative effect, the other had marked efficacy until added trazodone. Conclusions SRMD can occur not only in infants, but also in adolescents and adults. Patients who have the problems of the sleep quality should be treated. Clonazepam can obviously relieve symptoms and improve sleep quality. Patients who do not have a good effect with clonazepam can try to add trazodone. Video-electroencephalography monitoring and interpreting it correctly are important to the diagnosis of paroxysmal disease.

关 键 词：夜间性肌阵挛综合征 脑电描记术 多道睡眠描记术 肌电描记术 氯硝西泮 曲唑酮 

分 类 号：R740[医药卫生—神经病学与精神病学]