Ms. Hochman et al., HYPEREKPLEXIA - REPORT OF A NONFAMILIAL ADULT-ONSET CASE ASSOCIATED WITH OBSTRUCTIVE SLEEP-APNEA AND ABNORMAL BRAIN NUCLEAR TOMOGRAPHY, Sleep, 17(3), 1994, pp. 280-283
We report the unique occurrence of hyperekplexia and obstructive sleep
apnea (OSA) in a 48-year-old male. Polysomnography and multiple sleep
latency testing excluded cataplexy, which can be confused with startl
e attacks. A new imaging finding was a nuclear tomography abnormality
in the left frontal lobe. We postulate that this finding may represent
a functional cortical lesion of a descending pathway that normally in
hibits the startle reflex. Serious complications of pharmacotherapy wi
th clonazepam, the drug of choice for hyperekplexia, can be avoided by
first evaluating for OSA.