Jactatio capitis nocturna with persistence in adulthood: case report

Abstract

Rhythmic movement disorder, also known as jactatio capitis nocturna, is an infancy and childhood sleep-related disorder characterized by repetitive movements occurring immediately prior to sleep onset and sustained into light sleep. We report a 19-year-old man with a history of headbanging and repetitive bodyrocking since infancy, occurring on a daily basis at sleep onset. He was born a premature baby but psychomotor milestones were unremarkable. Physical and neurological diagnostic workups were unremarkable. A hospital-based sleep study showed: total sleep time: 178 min; sleep efficiency index 35.8; sleep latency 65 min; REM latency 189 min. There were no respiratory events and head movements occurred at 4/min during wakefulness, stages 1 and 2 NREM sleep. No tonic or phasic electromyographic abnormalities were recorded during REM sleep. A clinical diagnosis of rhythmic movement disorder was performed on the basis of the clinical and sleep studies data. Clonazepam (0.5 mg/day) and midazolam (15 mg/day) yielded no clinical improvement. Imipramine (10 mg/day) produced good clinical outcome. In summary, we report a RMD case with atypical clinical and therapeutical features.

Atypical Headbanging Presentation of Idiopathic Sleep Related Rhythmic Movement Disorder: Three Cases with Video-Polysomnographic Documentation

“…(8) The knees were always drawn up during the atypical headbanging episodes, which may be part of the symptom complex for atypical headbanging, or may be a common supine sleeping posture for these patients. (9) Lack of neuropsychiatric disease with adult persistence of atypical headbanging in patient #3 was also found in various cases of adult persistence of typical headbanging [18][19][20][21] (and in other cases, as reviewed). 22 (10) Clonazepam therapy was reported to be effective in isolated cases of typical headbanging 17,20,23 but was effective in only 1 of our 3 patients.…”

Controlled Sleep Restriction for Rhythmic Movement Disorder

“…11 Although usually a self-limiting disorder, we believe RMD should be treated on diagnosis because treatment can prevent secondary social/psychological consequences, physical damage, 5,8 and persistent into adulthood. [2][3][4]12 Hypnotics alone may fail, 3 and movements can re-occur after treatment cessation. We do not know whether the treatment should be longer or shorter than our 3-week regimen, which was arbitrarily chosen.…”

The Primary Parasomnias

“…12,13 It is manifested as repetitive motions of the trunk, head, or extremities. Head movements are common, earning the condition the other term of "jactatio capitis nocturna."…”