RT Journal Article
SR Electronic
T1 REM sleep motor dysfunction in multiple system atrophy: with special emphasis on sleep talk as its early clinical manifestation
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 678
OP 681
DO 10.1136/jnnp.63.5.678
VO 63
IS 5
A1 N Tachibana
A1 K Kimura
A1 K Kitajima
A1 A Shinde
A1 J Kimura
A1 H Shibasaki
YR 1997
UL http://jnnp.bmj.com/content/63/5/678.abstract
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.