夜間睡眠中に異常行動を来し, 睡眠時ミオクローヌスを合併した心身障害の1例

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The patient was a 50-year old man who had various psychosomatic diseases, such as recurrent duodenal ulcer (stress ulcer), psychogenic impotence, psychogenic polakiuria, headache, and palpitation, complicated with parasomnia and nocturnal myoclonus snyndrome. At the age 7,his father died. Since then he was brought up by his mother alone. He was married when he was 27. During a few months after marriage he had a psychogenic impotence, but two children were born. He had been a manager of steelwork for ten years, when the presindent of the company changed. Because the new president was younger than him, the patient did not get along well with him. Since that time steelwork became inactive, stress around him became intensive. Some psychosomatic diseases, such as recurrent duodenal ulcer (stress ulcer), headache, palpitation and psychogenic polakiuria started to appear and impotence also reappeard. Since about two years ago he began to shout and throw things at midnight during sleep and sometimes he developed enuresis. After he awoke, he explained, "I had developed a terrible dream." Since this episode seemed to occur more frequently, he was admitted to our hospital for more complete examination of his sleep state. An all night sleep polysomnography test was recorded and a psychological test (draw a person test) was analyzed. We could find nocturnal myoclonus and insufficiency of his sexual identity. Subjectively he did not complain of insomnia and hypersomnia in spite of nocturnal myoclonus. It is recognized that nocturnal myoclonus and parasomnia (for example enuresis and night-mare) became worse by stress or psychological factors. But the pathogensis of nocturnal myoclonus and parasomnia is still unknown. We think that his stressful life and rigid character make this state worse, and at the same time abnormal behaviors during sleep make his stress more severe. On the other hand, this vicious circle disturbs the improvement of his various psychosomatic diseases (duodenal ulcer, etc.).
日本心身医学会の論文
1989-06-01

夜間睡眠中に異常行動を来し, 睡眠時ミオクローヌスを合併した心身障害の1例

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