Journal of Sleep Disorders: Treatment and CareISSN: 2325-9639

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Case Report, J Sleep Disor Treat Care Vol: 4 Issue: 4

Case Report: Disturbed Sleep in a Patient with Moyamoya Disease

Arina Bingeliene1,2*, Colin M Shapiro1,2, Sharon A Chung3 and Paul A Hwang4
1Department of Psychiatry, Faculty of Medicine, University of Toronto; Neuropsychiatry Program, Toronto Western Hospital, University Health Network, Canada
2Sleep Research Laboratory, Toronto Western Hospital, Canada
3Sleep Research Unit, Department of Psychiatry, University Health Network,Canada
4Department of Medicine, Institute of Medical Science, University of Toronto,Canada
Corresponding author : Dr. Arina Bingeliene, MD
Toronto Western Hospital, 399 Bathurst Street, 7-Main, Rm. 422, Toronto, Ontario, M5T2S8, Canada
Tel: 416-603-5273; Fax: 416-603-6919
Received: January 23, 2015 Accepted: November 04, 2015 Published: November 09, 2015
Citation: Bingeliene A, Shapiro CM, Chung SA, Hwang PA (2015) Case Report: Disturbed Sleep in a Patient with Moyamoya Disease. J Sleep Disor: Treat Care 4:4. doi:10.4172/2325-9639.1000164


Background: Moyamoya disease is a chronic, progressive occlusion of the circle of Willis arteries that leads to the development of characteristic collateral vessels. The incidence of moyamoya disease is highest in Japan, with 0.35 cases per 100,000 people. At this time, moyamoya disease is believed to be hereditary and the pathogenesis is unknown.

Case report: This case report describes an 11-year-old Asian girl diagnosed with idiopathic moyamoya disease. The patients have a history of severe migraines and sleep disturbances and experienced a stroke-like event with balance, coordination, sensory and motor function impairment. She was subsequently treated with three revascularisation surgeries. Prior to her presentation, the patient experienced severe migraines attacks 4-5 times per week, with migraines representing a primary concern since the age of 5. She experienced difficulties falling asleep and maintaining sleep and developed mood-related problems. A full montage electroencephalogram (EEG) showed abnormal background activity and revealed epileptiform changes. Following treatment of her sleep disturbance with Tryptophan, her migraines improved and functional abilities were also enhanced. Her improvement in sleep function was quantified via repeated polysomnographic studies and actigraphy monitoring between 1/2012 and 2/2014. Along with the details of this case, this article provides a review of the literature related to this condition.

Conclusion: This case report demonstrates that investigation of sleep-related concerns is able to provide a window into neurologic abnormalities, allowing for enhanced detection of these issues and improved therapeutic outcomes. A review of the literature indicates that little information is available related to the pathogenesis of moyamoya disease and that the presentation of sleep disturbances has not been widely reported. We believe this case report will help to improve understanding of the disease and its presentation.

Keywords: Moyamoya disease and sleep disturbances; Puff of smoke; Cerebral blood vessel occlusion

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