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Sleep attacks--apparent relationship to atlantoaxial dislocation.

C W Hall, D Danoff

    Archives of Neurology
    |January 1, 1975
    PubMed
    Summary
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    Disabling sleep attacks in a 47-year-old man were linked to atlantoaxial dislocation. Surgical fusion of the C-1 and C-2 vertebrae relieved these symptoms, suggesting impaired respiratory control.

    Area of Science:

    • Neurology
    • Neurosurgery
    • Sleep Medicine

    Background:

    • Sleep attacks are characteristic of narcolepsy but also occur in various metabolic and central nervous system disorders.
    • Many of these sleep-related disorders are challenging to treat effectively.
    • Atlantoaxial dislocation is a rare condition affecting the upper cervical spine.

    Purpose of the Study:

    • To investigate the potential link between atlantoaxial dislocation and disabling sleep attacks.
    • To evaluate the efficacy of surgical intervention for sleep attacks associated with cervical spine abnormalities.
    • To explore the underlying pathophysiology of sleep disturbances in atlantoaxial dislocation.

    Main Methods:

    • Case study of a 47-year-old male patient presenting with disabling sleep attacks.

    Related Experiment Videos

  • Diagnostic assessment including imaging to identify atlantoaxial dislocation and cervical canal stenosis.
  • Surgical treatment involving posterior fusion of the C-1 and C-2 vertebrae.

    • Main Results:

    • The patient exhibited atlantoaxial dislocation with significant narrowing of the sagittal cervical canal diameter (12 mm).
    • Despite spinal cord compression, symptoms were mild and intermittent, with no objective signs of neurological deficit.
    • Post-surgical posterior fusion of C-1 and C-2 vertebrae led to complete resolution of sleep attacks.

    Conclusions:

    • Atlantoaxial dislocation can manifest as disabling sleep attacks, mimicking narcolepsy.
    • Surgical stabilization of the C-1 and C-2 vertebrae can effectively treat sleep attacks in this context.
    • Impaired efferent control of respiration is proposed as the mechanism underlying these sleep disturbances.