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Yıl:2013; Cilt: 6; Sayı: 3>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2013;6(3):53-59
Uykuda Hareket Bozuklukları ve Tedavisi
EÖ Ertuğrul, L Hanoğlu
İstanbul Özel Medipol Hastanesi, İstanbul
Uyku ile ilişkili hareket bozuklukları 2005 yılında tekrar yapılandırılan Uluslararası Uyku Bozuklukları Sınıflamasına göre; huzursuz bacaklar sendromu, uykuda periyodik hareket bozukluğu, nokturnal bacak krampları, bruksizim ve ritmik hareket bozukluğu şeklinde sınıflandırılmıştır. Bu hastalıklardan en sık görüleni Huzursuz bacaklar sendromudur. Patofizyolojisinde özellikle demir metabolizması ve dopaminerjik sistem bozuklukları saptanmıştır. Tedavide dopaminerjik ajanlar belirgin fayda sağlamaktadır. İkinci sıklıkla görülen uykuda periyodik hareket bozukluğu daha çok alt ekstremitelerde görülse de kollarda da olabilir. Huzursuz bacaklar sendromu ve diğer uyku bozuklukları ile sıklıkla birlikte bulunur. Dopaminerjik ajanların semptomlarda belirgin düzelme sağlaması patofizyolojide yine dopaminerjik sistem bozukluğunu düşündürür. Nocturnal bacak krampları sağlıklı erişkinlerde %16 görülebilen, kalsiyum metabolizma bozukluğunun neden olduğu düşünülen bir hastalıktır. Uyku ile ilişkili bruksizm %8 oranında görülen, yaşla sıklığı azalan, ailesel geçişi de olabilen bir hastalıktır. Uykuda ritmik hareket bozukluğu daha çok cocuklarda görülen, patofizyolojisi tam aydınlatılamamış, tedavi yanıtı iyi olan bir hastalıktır.
Sleep Related Movement Disorders and Treatment
Sleep related movement disorders were classified as Restless legs syndrome, periodic limb movement disorder, sleep-related leg cramps, sleep- related bruxism, sleep- related rhythmic movement disorder according to do restructured International sleep disorders classification at 2005. Among these, the most often seen disease is restless legs syndrome. Especially iron metabolism and dopaminergic system disfunctions were determined in the pathophysiology. In the treatment dopaminergic agents supplied a clear benefit. The second often seen periodic limb movement disorder can also be seen in the arms although its mostly seen in the legs. It can be oftenly seen together with the restless legs syndrome and the other sleep disorders.The dopaminergic agents that provides a clear recovery in the symptoms, gives the impression of dopaminergic system dysfunction in the pathophysiology. It is believed that calsium metabolism disfunction causes nocturnal leg cramps and it can be seen 16% of the healty adults. Sleep-related bruxism is a disease that can be seen in the avarage of 8%, frequency is reduced with the age, and the familiy transition is possible. Sleep related rhytmic movement disorder is a disease that is mostly seen in the children, the pathophysiology is unclear, can be well treated.

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