Sleep disorders and polysomnography findings in patients with autoimmune encephalitis

Background Sleep disorders in patients with autoimmune encephalitis (AE) are increasingly reported. Early recognition and treatment have significant importance regarding the potential of sleep disorders’ effect on morbidity and even mortality. There are a limited number of studies related to polysom...

Full description

Saved in:
Bibliographic Details
Published in:Neurological sciences 2023-04, Vol.44 (4), p.1351-1360
Main Authors: Erkent, Irem, Elibol, Bulent, Saka, Esen, Saygi, Serap, Tezer, Irsel
Format: Article
Language:English
Subjects:
Antibodies
Antigens
Apnea
Autoimmune diseases
Autoimmune Diseases of the Nervous System
Channel gating
Circadian rhythm
Circadian rhythms
Contactin
Diagnosis
EEG
Encephalitis
Female
Humans
LGI1 protein
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Neurology
Neuroradiology
Neurosciences
Neurosurgery
NREM sleep
Original Article
Patients
Polysomnography
Potassium channels (voltage-gated)
Psychiatry
REM Sleep Behavior Disorder
Seizures
Sleep - physiology
Sleep Apnea, Obstructive
Sleep disorders
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Sleep disorders in patients with autoimmune encephalitis (AE) are increasingly reported. Early recognition and treatment have significant importance regarding the potential of sleep disorders’ effect on morbidity and even mortality. There are a limited number of studies related to polysomnography (PSG) in these patients. Here, we report the clinical and PSG data of patients with AE and sleep disorders, with a particular interest in sleep-related breathing disorders (SRBD). Methods Seventeen patients with diagnosed AE and acute or subacute onset sleep complaints who underwent video-electroencephalography-PSG recordings in our tertiary center were investigated. Results The mean age was 50, with eight females and nine males. The detected antibodies were against leucine-rich glioma-inactivated 1(LGI-1) in 6, anti-contactin-associated protein-2(CASPR2) in 3, voltage-gated potassium channel complex antigens(VGKC) in 1, anti-glycine in 1, dipeptidyl-peptidase-like protein-6(DPPX) in 1, anti-Hu in 1, and anti-amphiphysin in 1. All commercially available and known autoimmune encephalitis-related antibodies were negative in 3 of the patients. Final diagnosis after PSG was circadian rhythm sleep disorder ( n  = 3), periodic limb movement disorder ( n  = 3), insomnia ( n  = 5), central apnea with or without Cheyne–Stokes breathing (CSB) ( n  = 4), obstructive sleep apnea (OSA) ( n  = 4), non-rapid eye movement (NREM) and REM parasomnia ( n  = 8), faciobrachial dystonic seizures ( n  = 2), and subclinical seizures ( n  = 1). Sleep microstructure was disrupted in 9, REM periods without atonia occurred in 4, and brief sleep fragments consisting of theta activity interspersed with faster rhythms existed in 7 patients. Nearly half of our patients (47%) had SRBD, and the mean apnea–hypopnea index (AHI) was 14. Conclusions Sleep disorders are frequent and essential components of AEs. Systematic clinical questionnaires and routine PSG assessments would significantly impact the correct diagnosis and proper treatment of SRBD and the overall prognosis of AE.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-022-06513-x