PT  - JOURNAL ARTICLE
AU  - N Tachibana
AU  - K Kimura
AU  - K Kitajima
AU  - A Shinde
AU  - J Kimura
AU  - H Shibasaki
TI  - REM sleep motor dysfunction in multiple system atrophy: with special emphasis on sleep talk as its early clinical manifestation
AID  - 10.1136/jnnp.63.5.678
DP  - 1997 Nov 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 678--681
VI  - 63
IP  - 5
4099  - http://jnnp.bmj.com/content/63/5/678.short
4100  - http://jnnp.bmj.com/content/63/5/678.full
SO  - J Neurol Neurosurg Psychiatry1997 Nov 01; 63
AB  - Various neurodegenerative diseases involving brainstem structures as one of the main pathological lesions are reported to be associated with REM sleep behaviour disorder. Full blown REM sleep behaviour disorder can be diagnosed clinically, but REM sleep motor dysfunction, a pathophysiological basis of REM sleep behaviour disorder, is difficult to detect without all night polysomnography. Twenty one consecutive patients with multiple system atrophy with no complaints of nocturnal abnormal behaviours were clinically evaluated to determine the presence of sleep related symptoms. All night polysomnography with video monitoring was performed to investigate REM sleep characteristics and patients’ behaviours. In 85.7% (18 of 21) of the patients’ sleep talk started or increased around or after the clinical onset of the primary diseases. REM sleep without atonia occupied more than 15%(16.2%-100%) of the REM sleep time in all but one patient. In 90.5% (19 of 21) of patients, motor events such as sleep talk and various combinations of craniofacial, orofacial, or limb movements occurred at various frequencies mostly during REM sleep without atonia. In patients with multiple system atrophy, REM sleep motor dysfunction is a common polysomnographic finding which is otherwise overlooked, and sleep talk may be its early clinical manifestation.