DREAMING AND PARASOMNIAS FROM A CEREBRAL STRUCTURAL VIEW

E. Elkan, Ana-Maria Papuc, Roxana Elena Bogdan Goroftei, E. Banu, M. Zlati, A. Albeanu, Alina Pleșea Condratovici
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Abstract

Introduction: Parasomnias are disorders that may appear during sleep with and/or without dreams. To describe them we must take in account a subjective description by the patient and his relatives. Objective measurement of this phenomenology is made with Polysomnography, Electromyography and Holter EKG. Material and Methods: We searched the recent data about parasomnia in the Medline, Pubmed, Google academic databases as also in classic books and reviews. Results: The clinical picture is various from motor and neurological signs to autonomic signs as also sleep related hallucinations. There are more rare presentations with associated disorders due to excretion and involuntary urinary emission during sleep disorders. Parasomnias are often preceded by a traumatic event for the patient and his family members which can be a head trauma or an infection or an intoxication which can be accompanied by psycho vulnerable events. On the other part parasomnias can be themselves a preamble announcing neurodegenerative diseases like Parkinson disease, Lewy Body Dementia or some synucleopathies. Conclusions: The fluctuations of neurotransmitters (Dopamine, Serotonine or Acetylcholine) due to specific neurologic pathology can lead to particular parasomnias, their evolution corresponding to each impairment. The knowledge of accompanying parasomnias of neurologic disorders like those from Parkinson disease helps manage diseases of neurological patients already known with Parkinson's disease or other neurological diseases, leading to increased quality of life for these patients as a result of specialized intervention.
从大脑结构的角度看做梦和异梦
睡眠异常是一种可能出现在睡眠中有梦或无梦的障碍。为了描述它们,我们必须考虑到病人及其亲属的主观描述。用多导睡眠图、肌电图和动态心电图对这一现象进行客观测量。材料和方法:我们在Medline, Pubmed,谷歌学术数据库以及经典书籍和评论中检索了有关睡眠异常症的最新数据。结果:临床表现多样,从运动和神经症状到自主神经症状,也有与睡眠有关的幻觉。在睡眠障碍期间,由于排泄和非自愿排尿而伴有相关疾病的更罕见的表现。异梦症通常发生在病人及其家人的创伤性事件之前可能是头部创伤或感染或中毒,这可能伴随着精神上的脆弱事件。另一方面,异梦本身也可能是神经退行性疾病的前兆,比如帕金森病、路易体痴呆或一些突触病。结论:神经递质(多巴胺、血清素或乙酰胆碱)的波动可导致特定的睡眠异常,其演变与每种损伤相对应。对帕金森病等神经系统疾病伴随的睡眠异常的了解,有助于管理已知患有帕金森病或其他神经系统疾病的神经系统患者的疾病,通过专门干预,提高这些患者的生活质量。
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