title: [Deficiency of REM sleep in a patient with pontine cavernous hemangioma].
abstract: A 15-year-old girl had no REM sleep presumably due to a pontine cavernous hemangioma was reported. Her brain MRI revealed a cavernous hemangioma extending from the dorsal pontine to the medulla. She manifested truncal ataxia, facial nerve palsy, and ocular motor apraxia. She could not sleep in the supine position due to the sleep apnea accompanied with loud snoring. Overnight polysomnography (PSG) was performed for detection of obstructive sleep apnea syndrome (OSAS). In addition to severe OSAS and Cheyne-Stokes-like respiration at wake after sleep onset, her 1st PSG study revealed no periods with rapid eye movement, EEG characteristic of REM sleep, atonia and variation on respiratory and heart rate. Even after effective therapy for OSAS with non-invasive positive airway pressure ventilation (NPPV), her 2nd PSG also failed to show stage REM. These findings suggest that this pontine cavernous hemangioma disturbed her REM-on system. This is the first report of an individual with long-term loss of REM sleep and a valuable case for the understanding of anatomical structures of the REM-on system and the role of REM in memory consolidation.
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka. kuriko@ped.med.osaka-u.ac.jp
authors.forename: Kuriko
authors.initials: K
authors.lastname: Kagitani-Shimono
authors.forename: Kumi
authors.initials: K
authors.lastname: Kato-Nishimura
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitai
authors.forename: Ken
authors.initials: K
authors.lastname: Araya
authors.forename: Koji
authors.initials: K
authors.lastname: Tominaga
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okinaga
authors.forename: Ikuko
authors.initials: I
authors.lastname: Mohri
authors.forename: Masako
authors.initials: M
authors.lastname: Taniike
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
mesh_terms: D000293:Adolescent; D020295:Brain Stem Neoplasms / Q000150:complications* / Q000175:diagnosis; D002639:Cheyne-Stokes Respiration / Q000209:etiology; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D009765:Obesity / Q000150:complications; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology; D012892:Sleep Deprivation / Q000175:diagnosis / Q000209:etiology*