Hypersomnia in stroke ischemic

Abstract

Hypersomnia/excessive daytime sleepiness post-stroke is a condition of prolonged daytime napping and nighttime sleep following a cerebrovascular accident. The incidence of sleep disorders occurs in more than 40% in the chronic phase and 70% in the acute phase. The incidence of hypersomnia increases in the first month after stroke. Based on observations by Von Economo found that symptoms of excessive sleepiness are often found in individuals with lesions in the junction area between the posterior hypothalamus and mesencephalon. Drowsiness can be caused by the presence of a direct lesion in the Reticular formation, which located in the midline region of the diencephalic structure caused by the involvement of the fibers tract, which builds Ascending Reticular Activating System (ARAS). ARAS is a central nervous system that has functions as a promotor of the sleep-wake process. There have been few cases of the mesencephalon and cerebellar infarction that affect the ARAS, which causes excessive drowsiness and hypersomnia. This case will present a patient with ischemic stroke in the mesencephalon and cerebellar regions that affect the ARAS, thus providing symptoms of excessive drowsiness, nystagmus, multiple cranial nerve palsy and spastic hemiparesis due to the presence of several atherosclerotic plaques in the posterior circulations. This study used the Epworth Sleepiness Scale questionnaire to establish a diagnosis of hypersomnia. The administration of therapy depends on the underlying cause.

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