The effect of sleep on the dyskinetic movements of Parkinson's disease, Gilles de la Tourette syndrome, Huntington's disease, and torsion dystonia
D. R. Fish, D. Sawyers, P. J. Allen, J. D. Blackie, A. J. Lees and C. D. Marsden
University Department of Clinical Neurology, Institute of Neurology, London, England.
The effect of sleep on the involuntary movements or dyskinesias in
Parkinson's disease, Huntington's disease, primary and secondary torsion
dystonia, and Gilles de la Tourette syndrome was studied in a total of 52
patients and 10 normal subjects using video electroencephalographic
telemetry. Movements typical of the wake pattern were seen occasionally
during unequivocal sleep in all but two completed studies, and in each
condition reappeared under similar circumstances. The movements were most
likely to occur after awakenings or lightenings of sleep, or in stage one
sleep. The movements were very rare during the deeper phases of sleep.
Those movements that occurred during sleep without awakenings were usually
preceded by arousal phenomena and, rarely, by sleep spindles or slow waves.
The control group showed normal "semipurposeful" movements under the same
conditions during sleep. The rare appearance of the different dyskinesias
and normal movements under similar circumstances during sleep could be a
result of common effects on the generator systems or changes in the
excitability of the final common motor pathway.
