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Chapter 31 - Brain tumors, infections, and other CNS causes of sleepiness

from Section 3 - Medical, Psychiatric and Neurological Causes Of Sleepiness

Published online by Cambridge University Press:  04 February 2011

By
Mari Viola-Saltzman  and
Nathaniel F. Watson
Edited by
Michael J. Thorpy  and
Michel Billiard
Michael J. Thorpy
Affiliation:
Sleep-Wake Disorders Center, Montefiore Medical Center, Bronx, NY, USA
Michel Billiard
Affiliation:
Guide Chauliac Hospital, Montpellier, France
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Summary

This chapter focuses on CNS pathology directly causing sleepiness, as opposed to pathology that causes sleep disorders that result in sleepiness. Focal lesions cause sleepiness by directly involving one (or more) of the neuroanatomic regions subserving sleep or wakefulness. Paraneoplastic disorders such as anti-Ma2 encephalitis are also associated with sleepiness. Ma-2 is an onconeuronal protein linked with testicular and lung cancer. Methylphenidate, amphetamines, and modafinil are effective in the treatment of sleepiness in children with brain tumors. Infectious processes of the CNS, both diffuse and focal, can result in excessive sleepiness. Antiretroviral drugs, efavirenz and nevirapine have been linked to sleep disruption and vivid dreams, and zidovudine causes insomnia. The neuroanatomy of sleep and wakefulness is a complex interplay between numerous wake- and sleep-promoting centers and circadian factors. Hypothalamic damage, whether from neoplasm, stroke, multiple sclerosis (MS) plaque or neurocysticercosis, can result in the same secondary narcolepsy phenotype.

Keywords

electrodiagnostic testingelectromyographyexcessive sleepinesssubtle peripheral neuropathiesrestless legs syndromeperiodic limb movement disorderinsomnia
Type
Chapter
Information
Sleepiness
Causes, Consequences and Treatment
 , pp. 351 - 363
Publisher: Cambridge University Press
Print publication year: 2011

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