Relapsing-remitting autoimmune agrypnia.
A woman affected by multiple cranial nerve palsy developed several episodes of total insomnia and respiratory crises resulting from central breathing depression associated with dysautonomic symptoms. Oligoclonal IgG bands were present in her cerebrospinal fluid, and immunohistochemistry showed increased binding of serum and cerebrospinal fluid on gamma-aminobutyric acid-ergic, synapse-rich neuronal cells. Immunosuppressive treatment and plasma exchange were followed by clinical improvement, with restoration of sleep architecture and disappearance of respiratory crises, suggesting autoimmune pathogenesis of the syndrome.
Batocchi
A P
AP
Institute of Neurology, Catholic University, Rome, Italy. adeangelis@rm.unicatt.it
Della Marca
G
G
Mirabella
M
M
Caggiula
M
M
Frisullo
G
G
Mennuni
G F
GF
Tonali
P A
PA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis*; D001342:Autonomic Nervous System Diseases / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis*; D003389:Cranial Nerve Diseases / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D010951:Plasma Exchange; D017286:Polysomnography; D012008:Recurrence; D012074:Remission Induction; D012131:Respiratory Insufficiency / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis*; D007319:Sleep Initiation and Maintenance Disorders / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis*; D013577:Syndrome; D014832:Voice Disorders / Q000209:etiology
D000305:Adrenal Cortex Hormones; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents