Objective: To prospectively study sleep and other non motor symptoms among patients with craniofacial dystonias.

Background: Craniofacial dystonia have been shown to be associated with non-motor symptoms such as depression, poor quality of life and impaired sleep. Connections of the cortico-striatal-thalamic – pallidal circuit with other networks of the cortex play role in non motor syndrome of dystonia

Methods: The study was conducted at the department of Neurology, NIMHANS , India . Patients with craniofacial dystonia (cervical dystonia (CD), blepharospasm (BS) , oromandibular dystonia (OMD) and Meig’s syndrome(MG)) were assessed by a questionnaire to evaluate depression , restless leg syndrome, sleep quality , self-esteem and daytime sleepiness. Overnight polysomnography was conducted in 12 patients with cervical dystonia.

Results: Sixty seven patients (CD= 39, BS=12, OMD= 7, MG = 7) were recruited into the study. Among these, 64.2 (n=43) were males and 35.8 (n=24 were females). The mean age of onset is 44.7±13.3 years. Craniofacial dystonia affected occupation in 55.2 %(n= 37), affected social interaction in 77.6 %(n=52), affected sleep in 28.4 (n=19) and affected activities of daily living in 59.7%(n=40) of the individuals. The mean Pittsburg Sleep Quality Index score (PSQI) score was 3.34(normal), Rosenberg self-esteem questionnaire was 19.25,(normal) Epworth sleepiness score (ESS)was 6.5(high normal) and Hamilton depression score(HAM-D) was 11.4(mild depression). The sleep efficiency had significant positive correlation with depression(p<0.001), self-esteem(p=0.001) and daytime sleepiness(p=0.03). Out of 39 patients with cervical dystonia, 30.8% (n=12) of patients presented with poor sleep efficiency, 12.8 % (n=5) presented with excessive daytime sleepiness and 63.1% (n=25) of patients had depression. Among individuals with cervical dystonia, there was no correlation between the non-motor symptoms and the severity of the dystonia. However significant correlation was found between the disability with depression(p<0.001), pain with depressive symptoms(p=0.02) . Polysomnography studies were done in 6 males and 6 females. Mean sleep efficiency was 54.5%. Mean overall sleep latency was 48.4 minutes. Mean REM latency was 108.7 minutes. In sleep,mean percentage of REM sleep was 18.5%, stage 1 sleep was 17.9 %, stage 2 sleep was 42. 8 % and stage 3 sleep was 21.1 %.

Conclusions: This study describes high prevalence of non-motor symptoms in Indian patients with cranial dystonia highlighting the need to address the non-motor symptoms in management.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-and-other-non-motor-symptoms-in-craniofacial-dystonia/