Bilateral paramedian thalamic syndrome: abnormal circadian wake-sleep and autonomic functions. Issue 6 (1st December 2002)

• Record Type: Journal Article
• Authors: Montagna, P; Provini, F; Plazzi, G; Vetrugno, R; Gallassi, R; Pierangeli, G; Ragno, M; Cortelli, P; Perani, D
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 73:Issue 6(2002)
• Page Start: 772
• Page End: 774
• Publication Date: 2002-12-01
• Subjects: thalamus -- circadian rhythm -- sleep; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.73.6.772
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objectives: To describe wake-sleep and body core temperature (t°) rhythm abnormalities in two patients with bilateral paramedian thalamic calcifications. Methods: Patients underwent (18F)FDG PET scans and 24 hour polygraphic recordings of wake-sleep and t°. Results: PET showed bilateral thalamic hypometabolism in both patients with additional basal ganglia or mesiolateral frontal and cingular hypometabolism. Wake-sleep studies showed abnormal sleep organisation and in the case with frontal and limbic PET hypometabolism, pre-sleep behaviour associated with "subwakefulness" EEG activities, lack of EEG spindles and K complexes, and features of status dissociatus. The t° rhythms showed increased mesor in both (37.4°C and 37.75°C) and inverted rhythm in one patient. Conclusions: Paramedian thalamic structures and interconnected, especially frontal and cingular, areas play a part in the organisation of the wake-sleep cycle and attendant autonomic functions.