Thalamus & Insomnia

  Are there any tumors or disorders of the Thalamus that would cause Insomnia.
  My sleep patterns changed in 1997 and found I was awakining at 3 or 4am in the morning. Went thru a period of insomnia where I would not sleep for 2 days and would be up for almost 70 hours. This subsided after about 4 weeks but still continued to awake at 4am.
  This same pattern returned in March of this year and has been continuing for about 5 weeks now.
  Have been reading about Fatal Familial Insomnia and other Prion Diseases and wounder if a disturbance of the Thalamus could be the problem?
  Would a neuro work up detect any Thalamic disorders?

[CCF Neuro[P] MD RPS]

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Dear Donald:
Sorry to hear about your trouble sleeping.  You are correct about FFI and other prion diseases implication in sleep disturbances.  However, although they are implicated the usual rapid pace that these diseases usually proceed would rule these entities out in your case.  These entities also have the symptoms of hallucinations, myoclonus, cortical spongiosis, ataxia, and profound mental status changes.  Yes, I think that thalamic processes might affect sleep, as we think that sleep spindles seen in stage II sleep are from the thalmus.  But this is a theoretical thought.  We know that patients with thalamic stroke have pain problems, difficult in initiating events, memory problems, disturbed consciousness, motor and sensory impairments etc. all depending on the locations within the thalamus.  As you do not describe any of these symptoms, I doubt that you have a thalamic lesion.  My suggestion, would be to see a sleep expert and have some testing performed.  As you know, a good nights sleep is worth it's weight
in gold.
Best of luck, I hope I answered you questions.
Sincerely,
CCF Neuro[P] MD