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Yıl:2015; Cilt: 52; Sayı: 2>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2015;52(2):204-206
İki Olgu Özelinde Uyku Terörü ve Tedavi Yaklaşımı
HS Turan, N Gündüz, A Polat, Ü Tural
Kocaeli Üniversitesi, Kocaeli
Parasomniler uykuya geçiş sırasında ya da uykunun devamında, istenilmeyen anormal davranışların, fiziksel aktivite ve otonomik uyarılma belirtilerinin ortaya çıkması olarak tanımlanmaktadır. Parasomniler içerisinde sınıflandırılan uyku terörü (UT), uykunun ilk saatlerinde, delta uykusu sırasında meydana gelen, ağlama ya da yüksek sesli çığlıkla başlayan, otonomik belirtilerde artışla karakterize ani korku ataklarıdır. Erişkinlikte UT yaşam boyu yaygınlığı %1’in altındadır. Parasomnilerin klinik değerlendirmesinde, yatak eşinden alınan anamnez çok önemlidir. Yine uyku günlüğü, video kaydı gibi yöntemler tanı koymada yardımcı olabilir. Kişinin tıbbi özgeçmişi, alkol-madde kullanım öyküsü, ruhsal travma yaşantıları, birincil ve ikincil kazançların varlığı ve ayrıntılı nörolojik değerlendirme tanıya giden yolda önem taşımaktadır. UT sıklığı fazla ve işlevselliği ciddi oranda etkiliyorsa trisiklik antidepresanlar (TSA) ve seçici serotonin geri alım önleyicileri (SSGÖ) tedavide tercih edilebilir. Benzodiazepinler bağımlılığa ve/veya ilacın kesilmesinden sonra daha şiddetli UT nöbetlerine neden olabileceği için tedavide öncelikli olarak tercih edilmemektedir. Bu yazıda erişkinlikte nadir görülen UT kliniği ve tedavisinde uzun etkili benzodiazepin kullanımı iki olgu temelinde tartışılacaktır.
Treatment Approach to Sleep Terror: Two Case Reports
Parasomnias are a group of disorders characterized by abnormal behaviors, physical activities, and autonomic arousal symptoms while transition to sleep or continuation of sleep. Sleep terror (ST) is classified under parasomnias characterized by sudden fear attacks beginning with crying attacks or high-frequency screams and continuing with increased autonomic symptoms. ST occurs in the first few hours of sleep during the delta phase. Further, the lifetime prevalence of ST in adults is less than 1%. It is important to obtain; anamnesis from patients’ bed partner for a clinical evaluation of ST. Methods, such as evaluating sleep diaries and video recordings, can help ST diagnosis. It is also important to evaluate patients’ medical history, history of substance or alcohol abuse, psychological traumatic experiences, primary or secondary incomes, and detailed neurological aspects. Physician can select some serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCADs) as medical treatment if patients have a high frequency of attacks. Because of addiction and relapse of ST episodes, benzodiazepines are not preferred as the first-line treatment. In this study, we will discuss ST, which is rare in adulthood, and use of long-acting benzodiazepine based on two cases.

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