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Le bâillement : de l'éthologie à la médecine clinique
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Yawning: its cycle, its role
Warum gähnen wir ?
 
Fetal yawning assessed by 3D and 4D sonography
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Le bâillement, du réflexe à la pathologie
Le bâillement : de l'éthologie à la médecine clinique
Le bâillement : phylogenèse, éthologie, nosogénie
 Le bâillement : un comportement universel
La parakinésie brachiale oscitante
Yawning: its cycle, its role
Warum gähnen wir ?
 
Fetal yawning assessed by 3D and 4D sonography
Le bâillement foetal
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mise à jour du
13 mars 2002
 Acta Neurol Belg
1994;94;(3):3;150-151
lexique
 Excessive yawning
B Van Sweden, L Vanderhoven, MG Van Erp
Medical Centre Sint-Jozef, Bilzen, Belgium

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Yawning is sociobiological stereotyped behaviour exhibiting an active involuntary deep inspiraion involving the mimic muscles. It probably represents an arousal defence reflex occurring at moments of increased vulnerability such as drowsiness (Askenasy 1989).
 
Pathophysiology an anatomical site are badly understood. In man the striatum, hypothalamus and brainstem have been implicated (Gschwend 1977; Sandyk 1987; Winalaratama 1988). Yawning may occur in physiological and pathological conditions (Blin 1991).
 
Excessive yawning as an isolated sign may represent a major diagnostic problem.
 
A 40 year old woman was refred for excessive continuous yawning with regular 1 Hz pattern and acute onset. She had received clonazepam, phenytoin, amitriptylin, procyclidinehydrochloride and flunarizine without sustained benefit. Neurological and CT investigations were normal. PSG-screening showed no signs of dys- or hypersomnia : two consecutive sleeprecordings showed a high sleep efficiency (94 &96%), normal REM latency (105 min.) and relative low SWS and REM percentages (8 & 15%). Respiration was regular, MSLT showed no increased sleep pressure. The patient took no drugs, except for estrogens.
 
In fact 7 days before symptom onset she had switched to a new hormonal preparation. She took 2 mg oestradiol combined with 1 mg cyproteronacetate (Climen) in a cyclical daily regimen. She had received gonadotropin (Humegon) and anti-estrogen (Clomid) treatments before. Ten days following estrogen withdrawal all symptoms had disappeared.
 
Recent neuropharmacological research favours the involvement of dopaminergic mechanisms, in yawning (Lal et al., 1987). This also opens the possibility of a hormonal modulation. Estrogens may induce chorea in patients with preexisting abnormalities of the basal ganglia showing altered central dopaminergic activity (Nausieda et al., 1986). However the effect of estrogens depends on the dose, the time interval, the type of behaviour measured and the part of the basal ganglia involved (Van Hartesveldt and Joyce, 1986). This partly explains the controversial data regarding, estrogen induced DA-receptor hyper- or hyposensitivity. Experimental results suggest a pathogenetic hyposensitivity of DA autoreceptors (Piccardi et al 1983). Apomorphine stimulates DA autoreceptors and induces yawning, in both animals and man (Lal et al., 1987). In animals it is a predominantly male phenomenon, but human observations suggest an eventual species and gender difference. Although other neurochernical disturbances have been implicated (Blin et al., 1991) this observation may sharpen our attention to hormonal status and gender effects in patients complaining of excessive yawning.
 
See baillements iatrogènes
 
Philibert C, Sauveplane K, Pinzani-Harter V et al. Le bâillement: de la physiologie à la iatrogénie. La lettre du pneumologue. 2011;14(5):168-172