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June 1945

DISTURBANCES IN SLEEP MECHANISM: A CLINICOPATHOLOGIC STUDYI. LESIONS AT THE CORTICAL LEVEL

Author Affiliations

NEW YORK; MEDICAL CORPS, ARMY OF THE UNITED STATES

From the Neuropsychiatric Service and the Neuropathological Laboratory of the Montefiore Hospital, and the Neurological Department of Columbia University College of Physicians and Surgeons.

Arch NeurPsych. 1945;53(6):399-406. doi:10.1001/archneurpsyc.1945.02300060002001
Abstract

Disturbances in sleep consisting of insomnia or hypersomnia can be divided into three main groups: those associated with lesions of the nervous system, those caused by use of drugs and those of psychogenic origin. In this presentation we shall be concerned essentially with hypersomnia caused by lesions of the central nervous system. Although this topic has been the subject of numerous contributions, the material under observation justifies a revaluation of this interesting problem. Attempts to explain the mechanism concerned in disturbances of sleep in man on a neuroanatomic and physiologic basis have led to various interpretations. The problem is beset with difficulties because the lesions in many of our cases and in those reported by other investigators were neither single nor limited to specific areas in the nervous system. This is especially true when the somnolence is associated with cerebrovascular lesions or diseases with bilateral or multiple lesions of the

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