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Première conférence internationale sur le bâillement
 
First International Conference on Yawning
 
Paris 24 - 25 juin 2010
 
Galerie des Photos de FICY
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 sundar
 
Yawning and stroke
 
Ramachandran Meenakshisundaram
Senior resident and research scholar in Internal Medicine, Madras Medical College, Chennai, India
 
Ponniah Thirumalaikolundusubramanian
Emeritus Professor in Internal Medicine, The Tamil Nadu Dr.M.G.R Medical University, Chennai, India
 
Arunachalam Muthusundari
Tirunelveli Medical College, Tirunelveli, India.
 
Shah Sweni
University of Debrecen, Medical and Health Science Center, Debrecen, Hungary.
 
Excessive or pathological yawning, is defined as a compulsive, repetitive action that is not triggered by appropriate stimuli such as fatigue or boredom. We will present the first study, including all admissions in our stroke's unit, during which we count, analyze all the yawns that occur during the first day after the stroke's onset, compare clinical status and imagery. We propose to give a new significance to them: the loss of cortical inhibition following stroke releases a hidden function, phylogenetically more primitive. Face-scratching, nose-face rubbing, yawning, and sighs are automatisms frequently reported after epileptic seizures. These behaviours are also considered a characteristic pattern in healthy subjects upon waking. Movement speed and repetition are the factors that vary, based on whether the context is physiological (sleep, arousal) or pathological (epileptic seizure, stroke). These behaviours are related to the brainstem and diencephalic activation that occurs when the cortex is disconnected from these areas (where the "central pattern generators" are located) by an epileptic discharge or a stroke. Adaptive behaviours depend on interactions between neural networks at various levels, requiring continuous mutual feedback. Yawning is an exterior manifestation of the tonic stimulation of the cortex by subcortical structures, particularly when the brainstem does not receive appropriate feedback from the cortex.
Background:
Yawning is phylogenetically ancient and associated with stereo typed behavioral pattern.
Objective:
To describe the pattern of associated movements observed in hemiplegic limbs during yawning and its relationship with gender, side of hemiplegia and tone of muscles.
Material and methods:
An observational study was designed in 75 newly detected anterior circulatory stroke patients due to ischemia or hemorrhage in internal capsule region. The cases were free from any arthropathy, auto immune disease, muscular disorders and injury deformity. The data were analyzed statistically.
Results:
There were 48 males and 27 females, whose median age was 48 and 47 respectively. The median time for the onset of yawning after stroke in males and females was 36 and 38 hours, respectively. Associated movements in hemiplegic limbs during yawning were minimal and observed in 59 (78.6%) of hemiplegics; and significantly more in males (83%) than females (70%), left sided (94%) than right sided hemiplegics (64%), those with hypotonia (71%) than hypertonia (61%), upper limb (91%) than lower limb (83%), and proximal than distal joint, irrespective of limb.
Conclusion:
The appearances of associated movements in hemiplegic limbs indicate the return of ancestral function observed in quadrupeds. However further studies are needed to elicit the reasons for such variations and utilization of associated movements in rehabilitation programs.
 
Excessive or pathological yawning, is defined as a compulsive, repetitive action that is not triggered by appropriate stimuli such as fatigue or boredom. We will present the first study, including all admissions in our stroke's unit, during which we count, analyze all the yawns that occur during the first day after the stroke's onset, compare clinical status and imagery. We propose to give a new significance to them: the loss of cortical inhibition following stroke releases a hidden function, phylogenetically more primitive. Face-scratching, nose-face rubbing, yawning, and sighs are automatisms frequently reported after epileptic seizures. These behaviours are also considered a characteristic pattern in healthy subjects upon waking. Movement speed and repetition are the factors that vary, based on whether the context is physiological (sleep, arousal) or pathological (epileptic seizure, stroke). These behaviours are related to the brainstem and diencephalic activation that occurs when the cortex is disconnected from these areas (where the "central pattern generators" are located) by an epileptic discharge or a stroke. Adaptive behaviours depend on interactions between neural networks at various levels, requiring continuous mutual feedback. Yawning is an exterior manifestation of the tonic stimulation of the cortex by subcortical structures, particularly when the brainstem does not receive appropriate feedback from the cortex.
 

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