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 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 http://www.baillement.com

mystery of yawning 

 

 

mise à jour du
19 mai 2020
Neurology
2020;94:1-2
Teaching Video Neuroimages: Pathologic yawning
 
A sign of brainstem involvement
in acute disseminated encephalomyelitis?
 
Veronica Birca, Christine Saint-Martin and Kenneth A. Myers
 
From the Department of Pediatrics (V.B., K.A.M.), Division of Child Neurology, and Department of Medical Imaging (C.S.-M.), Montreal Children's Hospital; Department of Neurology & Neurosurgery (K.A.M.), and Research Institute of the McGill University Health Centre (K.A.M.), McGill University Health Centre, Montreal, Canada.

Chat-logomini
 
 
A 15-year-old boy had acute-onset encephalopathy following a viral prodrome, associated with frequent, dramatic yawning without EEG change (video). There were no focal deficits on examination. CSF protein elevation (1.72 g/L) without pleocytosis, brain MRI, and significant improvement following methylprednisolone were consistent with acute disseminated encephalomyelitis (ADEM).
 
Pathologic yawning is described in other demyelinating diseases, neuromyelitis optica spectrum disorder and multiple sclerosis, but is rarely reported with ADEM. Although prior reports postulated that brainstem and hypothalamic lesions are responsible, yawning is a complex reflex mediated by both supratentorial and infratentorial structures; its precise localization is not yet defined.
 
Axial views show normal T1 (A), asymmetric T2 (B), and fluid-attenuated inversion recovery (FLAIR) (C) hyperintensity of the dorsal brainstem involving the reticular formation (arrowheads) at the level of cranial nerves V, VI, and VII nuclei, and T2 and FLAIR hyperintensity of the bilateral, left more than right, insula (arrows).
 
1°) Lana-Peixoto MA, Callegaro D, Talim N, et al. Pathologic yawning in neuromyelitis optica spectrum disorders. Mult Scler Relat Disord 2014;3:527&endash;532.
 
2°) Krestel H, Bassetti CL, Walusinski O. Yawning: its anatomy, chemistry, role, and pathological considerations. Prog Neurobiol 2018;161:61&endash;78.