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

Abstract

These 3 cases of idiopathic atypical headbanging expand the literature on this RMD variant, as to our knowledge only one previously documented case has been reported.

Head banging persisting during adolescence: A case with polysomnographic findings

“…We assume that by reducing the arousals, clonazepam improved the maintenance of sleep in the present case and thus was effective in the management of RMD. [2,[13][14][15][16] Thus, this case favors the arousal hypothesis of RMD. Arousal hypothesis is further supported by Attarian et al's report that described RMD in three successive generations and argued that inability to maintain continuous sleep could be an underlying pathology.…”

“…In subjects without co-morbid sleep apnea, clonazepam at bed time has been found effective in RMD. [ 13 14 15 ] On the other hand, as already discussed, CPAP therapy has also been found to reduce the frequency of RMD in cases with co-morbid sleep apnea. [ 2 16 ] In the present case, co-morbid sleep disorders were ruled out; hence, clonazepam was chosen.…”

Unusual Head Movements in Anti‐IgLON5 Disease

“…There is a certain resemblance with headbanging, a sleep‐related rhythmic movement disorder, usually seen in children and consisting of repetitive movements involving neck and trunk muscles emerging predominantly during wake–sleep transitions, that rarely persist during sleep 3 . Because the sleep‐related movements in our patient were semirhythmic and largely occurred during stages 2 and 3, we suggest describing them as “atypical headbanging ” 4 …”

A Case with Dopamine-Antagonist Responsive Repetitive Head Punching as Rhythmic Movement Disorder during Sleep

“…The repetitive movement like punching on the head in our case would be a rare form. There was a report of two cases in which typical rhythmic head banging after 3–4 years shifted to atypical head banging with frontal head punching what was quasi-rhythmic 2. Frequency of RMD can be variable, but generally ranges from 0.5 to 2 Hz.…”