REM narcolepsy, clinical polysomnographic and computerized electroencephalographic studies.

Abstract

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.