[Polygraphic study of narcolepsy during the nycthemeral period].
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Biomedical subjects
Publications and source records attributed to L Popoviciu.
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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.
2,698 epileptic patients were studied, 2,019 cases (64.3%) presenting temporal lobe epileptic attacks. Besides the routine EEG recordings and the corroboration of the clinical data with the meticulous observations by video monitoring on a closed circuit TV-screen (the patients being observe in a specially arranged room, provided with infra-red cameras), the diagnostic procedure was supported in all cases by several computerized EEG mappings, according to a model achieved by us, transcribing the primary data obtained by Hjorth's NSD parameters from the Siemens-Elema Mingograph to a Romanian M-118 microprocessor. In many cases we utilized an interface--built by us--for analog-digital conversion which allowed the direct introduction and conversion of amplitudes and frequencies from the Mingograph to the micro-computer. These were isolated to analyse the following electroclinical forms: 1. temporal absences: 360 cases (17.8%); 2. psychomotor attacks: 439 cases (21.7%) 3. psychosensory attacks: 77 cases (3.8%); 4. attacks with cognitive symptomatology: 260 cases (12.8%); 5. crises with ideative-affective symptomatology: 76 cases (3.8%); 6. vegetative attacks: 51 cases (2.5%); 7. akinetic attacks: 89 cases (4.4%); 8. focal temporal attacks secondarily generalized: 667 cases (33.0%). In 112 patients with nocturnal attacks, polysomnographic recordings were performed with sequential computerized EEG mappings during the various stages of sleep (concomitantly with the infrared video-TV monitoring).
Forty-two patients with myoclonic manifestations (especially during subacute sclerosing panencephalitis (SSPE)) were studied. The multidimensional investigations pointed out that myoclonias produce several EEG and polysomnographical perturbations: 1. Sleep disorganization; 2. Appearance of the myoclonic jerks in wakefulness (especially) and in some sleep stages; 3. Some electroclinical discordances; 4. A great variability of the myoclonias during some sleep stages; 5. EEG cortical mappings showed individual variabilities of Radermecker complexes.
One hundred and twelve patients with temporal lobe epilepsy were studied. Continuous polysomnographical recordings were performed for eight hours, the patients being video-monitored all the time. These researches, completed with computerized EEG cortical mappings demonstrated a peculiar activation of the temporal foci during REM phases and during some stages of LSWS.