Experts have warned against dismissing sleep disturbances in patients, saying they could provide the first signal of an underlying neuroimmunological disorder.
At the Congress of the European Academy of Neurology (EAN), researchers said insomnia or poor sleep quality can indicate antibody-mediated neuroimmunological illnesses. They cited three different cases which emphasised the importance of sleep history in the context of neurological disorders.
In one of these cases, a 69-year-old male had reported ‘strange behaviours’ during sleep, during which he fell out of bed twice. The patient was amnestic of the nocturnal behaviour. Sleep was not refreshing. He subsequently developed gait instability and ocular motor disturbance as well as chorea-like movement disorder. He was later diagnosed with anti-IgLON5 disease or autoimmune encephalopathy, with parasomnia and obstructive sleep apnoea.
In another case, a 33-year-old male with excessive daytime sleepiness, hypnagogic hallucination, and sleep paralysis was subsequently diagnosed with Ma2 antibody encephalitis associated with germ cell tumour.
“Taking a precise sleep history could offer a useful instrument to detect autoantibody-mediated neuroimmunological diseases in an early stage of disease,” the authors concluded.
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