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Case 36 - Restlessness and jerking upon recumbency when trying to fall asleep

from Part VII - Sleep-related movement disorders

Published online by Cambridge University Press:  10 November 2010

Antonio Culebras
Affiliation:
Upstate Medical University, New York
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Summary

This chapter discusses the case of a 56-year-old woman who was admitted to the hospital with a 2-year history of uncomfortable sensations with pain and paresthesia accompanied by an urge to move the legs at rest upon recumbency. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. Neurophysiology confirmed that these axial jerks occurred solely at the transition from wakefulness to sleep, during intrasleep arousal and upon awakening, that is, when the patient was relaxed but awake. Remarkably, propriospinal myoclonus (PSM) in the patient was observed to flare up at the transition from wakefulness to sleep and did not seem to relate only to the recumbency posture, but rather to vigilance level. The jerks could be promptly abolished by mental activation, even with the patient lying down, and immediately restarted when the patient was left alone undisturbed.
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Chapter
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Case Studies in Sleep Neurology
Common and Uncommon Presentations
, pp. 255 - 261
Publisher: Cambridge University Press
Print publication year: 2010

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