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Clinical Recovery and Sleep Architecture Degradation

Published online by Cambridge University Press:  18 September 2015

Vladimir C. Hachinski ,
Mortimer Mamelak  and
John W. Norris
Vladimir C. Hachinski*
Affiliation:
MacLachlan Stroke Unit, Sunnybrook Medical Centre, The University of Toronto, Toronto
Mortimer Mamelak
Affiliation:
Sleep Laboratory, Sunnybrook Medical Centre, The University of Toronto, Toronto
John W. Norris
Affiliation:
MacLachlan Stroke Unit, Sunnybrook Medical Centre, The University of Toronto, Toronto
*
University Hospital, P.O. Box 5339, London, Ontario, Canada N6A 5A5
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Abstract:

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We achieved a unique and timely recording of cerebral activity in a 70 year old woman immediately pre- and post-stroke, while studying the effect of acute cerebral infarction on sleep-electroencephalogram (EEG) patterns. Normal patterns, except for increased wakefulness, were recorded during two pre-infarct polysomnograms. Immediately following cerebral infarction increased delta activity was recorded from the infarcted hemisphere only. Initially, REM sleep could not be recorded from either side; however, on the third post infarct day REM sleep returned. Background EEG levels from both hemispheres became progressively slower, flatter and simpler. In addition, sleep spindles and the distinctive saw-tooth wave forms of sleep almost disappeared. At one year post-stroke sleep-EEG rhythm recordings from both hemispheres became more similar except for persisting delta activity from the left hemisphere. Unexpected deterioration of sleep-EEG pattern recordings from the undamaged hemisphere taken during the patient's clinical recovery remains unexplained. Serial sleep recording may facilitate the study of brain recovery, activity and reorganization following stroke.

Résumé:

RÉSUMÉ:

Nous avons réussi un enregistrement unique et opportun de l'activité cérébrale chez une femme âgée de 70 ans immédiatement pré- et post-accident cérébrovasculaire, pendant l'étude des effets de l'infarctus cérébral aigu sur le tracé électro-encéphalographique (EEG) enregistré pendant le sommeil. Un tracé normal, sauf pour une augmentation de l'état de veille, a été enregistré pendant deux polysomnogrammes pré-infarctus. Immédiatement après l'infarctus cérébral, une augmentation de l'activité delta a été enregistrée provenant de l'hémisphère infarcisé seulement. Initialement, le sommeil REM n'a pu être enregistré d'un côté comme de l'autre; cependant, le troisième jour post-infarctus, le sommeil REM est revenu. Le rythme de fond de l'EEG des deux hémisphères a ralenti progressivement, s'est aplati et simplifié. De plus, le fuseaux et les ondes en dents de scie caractéristiques du sommeil ont presque disparu. Un an après l'accident cérébrovasculaire, l'enregistrement du rythme électro-encéphalographique des deux hémisphères est devenu plus semblable, sauf pour la persistance d'activité delta à l'hémisphère gauche. Une détérioration imprévue du rythme EEG du sommeil à l'hémisphère non endommagé enregistré pendant la récupération clinique de la patiente demeure inexpliquée. Des enregistrements sériés pendant le sommeil pourraient faciliter l'étude de la récuperation, le l'activité et de la réorganisation cérébrales à la suite d'un accident cérébrovasculaire.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 17 , Issue 3 , August 1990 , pp. 332 - 335
Copyright
Copyright © Canadian Neurological Sciences Federation 1990

References

REFERENCES

1. Hachinski, VC, Mamelak, M, Norris, JW. Sleep morphology and prognosis in acute cerebrovascular lesions. In: Meyer, J, Lechner, H, Reivich, M, eds. Cerebral vascular disease Amsterdam-Oxford: Excerpta Medica, Elsevier, 1977; 69–71.Google Scholar
2. Hachinski, VC, Mamelak, M, Norris, JW. Prognostic value of sleep morphology in cerebral infarction. In: Meyer, J, Lechner, H, Reivich, , eds. Cerebral vascular disease. Proceedings of the 9th international Salzburg conference on cerebral vascular disease North Holland: Excerpta Medica, Elsevier, 1979; 287–291.Google Scholar
3. Hachinski, VC, Mamelak, M, Norris, JW. Sleep architecture and recovery from stroke. In: Masland, RL, Portera-Sanchez, A, Toffano, G, eds. Neuroplasticity: a new therapeutic tool in the CNS pathology. Fidia Research Series, Vol. 12. Padova: Liviana Press, 1987; 179–184.Google Scholar
4. Rechtschaffen, A, Kales, A. A manual for standardized terminology, techniques and scoring system for sleep stages of human subjects. U.S. Department of Health, Education and Welfare Publication No. 204, U.S. Government Printing Office, Washington,D.C.: 1968.Google Scholar
5. Bergamasco, B, Bergamini, L, Doriguzzi, T, et al. EEG-sleep patterns as a prognostic criterion in post-traumatic coma. Electroencephalo Clin Neurophysiol 1968; 24: 374–377.CrossRefGoogle ScholarPubMed
6. Bricolo, A, Gentilomo, A, Rosadini, G, et al. Long-lasting posttraumatic unconsciousness. A study based on nocturnal EEG and polygraphic recording. Acta Neurol Scand 1968; 44: 513–532.Google Scholar
7. Lessard, CS, Sances, A Jr, Larsen, SJ. Period analysis of EEG signals during sleep and post-traumatic coma. Aerospace Med 1974; 45: 664–668.Google Scholar
8. Kiloh, L, Mccomas, A, Osselton, J. Clinical Electroencephalography, 3rd Edition. London: Butterworlhs, 1972; 125–138.Google Scholar
9. Jouvet, M. Neurophysiology of the states of sleep. Physiol Rev 1967; 47: 117–177.Google Scholar
10. Greenberg, R. Cerebral cortex lesions: The dream process and sleep spindles. Cortex 1966; 2: 357–366.CrossRefGoogle Scholar
11. Reivich, M, Jones, S, Castano, T, et al. A model of diaschisis in the cat using middle cerebral artery occlusion. In: Ingvar, H, Lassen, V, eds. Cerebral function, metabolism and circulation. Copenhagen: Munhsgaard, 1977; 242–243.Google Scholar
12. Slater, R, Reivich, M, Goldberg, H, et al. . Diaschisis with cerebral infarction. Stroke 1977; 8: 684–690.CrossRefGoogle ScholarPubMed
13. Heiss, DW, Zeiler, K, Havelec, L, et al. . Long term prognosis in stroke related to cerebral blood flow. Arch Gen Neurol 1977; 34: 671–676.Google Scholar