ABNORMAL MOVEMENTS IN SLEEP AS A POSTPOLIO SEQUELAE

Nearly two-thirds of polio survivors report abnormal movements in slee p, with 52% reporting that their sleep is disturbed by these movements . Sleep studies were performed in seven polio survivors to document ob jectively abnormal movements in sleep. Two patients demonstrated gener alized random myoclonus, with brief contractions and even ballistic mo vements of the arms and legs, slow repeated grasping movements of the hands, slow flexion of the arms, and contraction of the shoulder and p ectoral muscles. Two other patients demonstrated periodic movements in sleep with muscle contractions and ballistic movements of the legs, t wo had periodic movements in sleep plus restless legs syndrome, and on e had sleep starts involving only contraction of the arm muscles. Abno rmal movements in sleep occurred in Stage II sleep in all patients, in Stage I in some patients, and could significantly disturb sleep archi tecture even though patients were totally unaware of muscle contractio ns. Poliovirus-induced damage to the spinal cord and brain is presente d as a possible cause of abnormal movements in sleep. The diagnosis of post-polio fatigue, evaluation of abnormal movements in sleep, and ma nagement of abnormal movements in sleep using benzodiazepines or dopam imetic agents are described.