Nocturnal sleep in mentally retarded infants with cerebral palsy.

Abstract Sleep EEG patterns in 23 mentally retarded children with cerebral palsy (CP) from 4 months to 5 years of age) and 39 reference mentally retarded children of no abnormality with the exception of psychomotor retardation (from 4 months to 12 years of age) were studied throughout nocturnal sleep, and the following results were obtained. 1. (1) Eleven CP cases and 30 references cases evidenced normal sleep patterns that could be classified into 6 stages. 2. (2) Twelve other cases in CP and 9 reference cases showed some abnormal sleep EEG patterns as follows: (i) in CP cases absence of EEG patterns characteristics of wakefulness, NREM sleep and REM sleep without spindles (n=3); porencephaly with microcephaly (n=1) and cytomegalovirus infection (n=2), no characteristic EEG patterns of stages 1–4 without spindles (n=2); cardiac arrest (n=1) and agenesis of corpus callosum with lissencephaly (n=1), absence of REM sleep (n=1); kernicterus, spindles with an extremely low incidence (n=5); perinatal anoxia (n=2), kernicterus (n=1), Lesch-Nyhan syndrome (n=1) and cerebral palsy due to unknown etiologies (n=1), and extreme spindles (n=1); cerebral palsy due to unknown etiologies, (ii) in reference cases no spindles (n=2), spindles with an extremely low incidence (n=6) and extreme spindles (n=1). 3. (3) Short sleep and long waking times during the night were noted in 4 out of 23 CP subjects; kernicterus (n=2), agenesis of corpus callosum with lissencephaly (n=1), and porencephaly with microcephaly (n=1). 4. (4) A long-term rhythm was found in the form of a fluctuation in integrated delta values through the night in 18 out of 23 CP subjects and in all reference subjects. However, such a periodic rhytmmicity was not observed in the remaining 5 CP subjects with cytomegalovirus infection (n=2), cardiac arrest (n=1), agenesis of corpus callosum with lissencephaly (n=1), and porencephaly with microcephaly (n=1). 5. (5) A significant decrease of DQ was found in CP subjects with all or 1–4 stages indistinguishable, short sleep and long wakefulness, and no delta rhythmicity in integrated records as compared to those with all the normal stages.