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Extreme sleep pattern in Lewy body dementia : A hypothalamic matter?

Londos, Elisabet LU ; Hansson, Oskar LU ; Rosén, Ingmar LU and Englund, Elisabet LU (2019) In BMJ Case Reports 12(3).
Abstract

Excessive sleep during the night and for >2 hours during the day is part of the fluctuating wakefulness criterion of dementia with Lewy bodies (DLB). The phenomenon â € sleep days' is not uncommon in nursing homes. Here, we describe a woman who, for months, slept for 3 days and nights in a row and thereafter was awake for 3 days and nights. Electroencephalogram (EEG) showed slow background activity and increased delta activity. No epileptiform activity was detected. Polysomnography showed a severely disturbed, markedly fragmented sleep pattern. On her death, neuropathology revealed degeneration and loss of neurons along with α-synuclein-containing Lewy body inclusions and neurites in the substantia nigra, locus coeruleus,... (More)

Excessive sleep during the night and for >2 hours during the day is part of the fluctuating wakefulness criterion of dementia with Lewy bodies (DLB). The phenomenon â € sleep days' is not uncommon in nursing homes. Here, we describe a woman who, for months, slept for 3 days and nights in a row and thereafter was awake for 3 days and nights. Electroencephalogram (EEG) showed slow background activity and increased delta activity. No epileptiform activity was detected. Polysomnography showed a severely disturbed, markedly fragmented sleep pattern. On her death, neuropathology revealed degeneration and loss of neurons along with α-synuclein-containing Lewy body inclusions and neurites in the substantia nigra, locus coeruleus, hypothalamus, and neocortex, thus fulfilling the criteria of DLB, cortical type. We propose that the hypothalamic degeneration contributed significantly to the clinical profile in this case. We suggest that patients with sleep days should be investigated for other DLB signs.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
memory disorders, sleep disorders (neurology)
in
BMJ Case Reports
volume
12
issue
3
publisher
BMJ Publishing Group
external identifiers
  • scopus:85062712792
ISSN
1757-790X
DOI
10.1136/bcr-2018-228177
language
English
LU publication?
yes
id
a377aed3-50be-477d-961c-4e6a55981a92
date added to LUP
2019-03-20 08:25:09
date last changed
2019-04-23 04:47:00
@article{a377aed3-50be-477d-961c-4e6a55981a92,
  abstract     = {<p>Excessive sleep during the night and for &gt;2 hours during the day is part of the fluctuating wakefulness criterion of dementia with Lewy bodies (DLB). The phenomenon â € sleep days' is not uncommon in nursing homes. Here, we describe a woman who, for months, slept for 3 days and nights in a row and thereafter was awake for 3 days and nights. Electroencephalogram (EEG) showed slow background activity and increased delta activity. No epileptiform activity was detected. Polysomnography showed a severely disturbed, markedly fragmented sleep pattern. On her death, neuropathology revealed degeneration and loss of neurons along with α-synuclein-containing Lewy body inclusions and neurites in the substantia nigra, locus coeruleus, hypothalamus, and neocortex, thus fulfilling the criteria of DLB, cortical type. We propose that the hypothalamic degeneration contributed significantly to the clinical profile in this case. We suggest that patients with sleep days should be investigated for other DLB signs.</p>},
  articleno    = {e228177},
  author       = {Londos, Elisabet and Hansson, Oskar and Rosén, Ingmar and Englund, Elisabet},
  issn         = {1757-790X},
  keyword      = {memory disorders,sleep disorders (neurology)},
  language     = {eng},
  number       = {3},
  publisher    = {BMJ Publishing Group},
  series       = {BMJ Case Reports},
  title        = {Extreme sleep pattern in Lewy body dementia : A hypothalamic matter?},
  url          = {http://dx.doi.org/10.1136/bcr-2018-228177},
  volume       = {12},
  year         = {2019},
}