Rapid Eye Movement Sleep Behavior Disorder in a Patient with Brainstem Lymphoma

Chen, Jianhua; Liu, Xiuqin; Cui, Quancai; Sun, Hao; Yan, Hong‐Bin

doi:10.2169/internalmedicine.52.8786

Cited by 25 publications

(15 citation statements)

References 24 publications

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“…Other examples of secondary RBD include those caused by neurological lesion affecting sleep/wake regulatory brain regions, most commonly within the brainstem. RBD due to lesions is rare and most commonly associated with meningiomas and subsequent disruption of pontine REM-atonia structures ( 23 ), although cases of narcolepsy ( 24 ), pontine cavernoma ( 25 ), pontine lymphoma ( 26 ), multiple sclerosis ( 27 ), and acute inflammatory rhombencephalitis ( 28 ) all give further examples of RBD incidence secondary to lesion.…”

Section: Symptoms and Diagnostic Considerationsmentioning

confidence: 99%

A Neurologist's Guide to REM Sleep Behavior Disorder

et al. 2020

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REM Sleep Behavior Disorder (RBD) is a chronic sleep condition characterized by dream enactment and loss of REM atonia. Individuals often present to clinic with complaints of injury to themselves or their bed-partner due to violent movements during sleep. RBD patients have a high risk of developing one of the neurodegenerative α-synucleinopathy diseases: over 70% will develop parkinsonism or dementia within 12 years of their diagnosis. RBD patients also exhibit accelerated disease progression and a more severe phenotype than α-synucleinopathy sufferers without RBD. The disease's low prevalence and the relatively limited awareness of the condition amongst medical professionals makes the diagnosis and treatment of RBD challenging. Uncertainty in patient management is further exacerbated by a lack of clinical guidelines for RBD patient care. There are no binary prognostic markers for RBD disease course and there are no clinical guidelines for neurodegeneration scaling or tracking in these patients. Both clinicians and patients are therefore forced to deal with uncertain outcomes. In this review, we summarize RBD pathology and differential diagnoses, diagnostic, and treatment guidelines as well as prognostic recommendations with a look to current research in the scientific field. We aim to raise awareness and develop a framework for best practice for RBD patient management.

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Section: Symptoms and Diagnostic Considerationsmentioning

confidence: 99%

A Neurologist's Guide to REM Sleep Behavior Disorder

et al. 2020

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“…Rapid eye movement sleep behavior disorder (RBD) is frequent in patients with neurodegenerative diseases. RBD was associated with the risk of developing brainstem lymphoma 22 . Above evidence indicated that cancer frequently occurs in many individuals with parasomnias.…”

Section: Introductionmentioning

confidence: 95%

Risk of Cancer in Patients with Insomnia, Parasomnia, and Obstructive Sleep Apnea: A Nationwide Nested Case-Control Study

Fang¹,

Miao²,

Chen³

et al. 2015

J. Cancer

106

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Purpose: Insomnia, parasomnia, and obstructive sleep apnea have been associated with a number of disease pathologies, but little is known about the relationship of these sleep disorders and cancer. The study explored the risk of sleep disorder (SD)-induced cancer using nationwide population data. Two million data from the National Health Insurance system of Taiwan was used to assess for the relationship.Patients and Methods: Patients with cancer as our cases and patients without cancer as our control group in 2001-20011. The study patients were traced back to seek the exposure risk factor of sleep disorders, which was divided into three categories: insomnia, obstructive sleep apnea (OSA) and parasomnia. Patients were selected excluding patients who had cancer prior to presenting with the sleep disorder and the person-year is less than 2 years. Each case was randomly matched with two cases with the same age, gender, and index year.Results: There were significantly increased risks of breast cancer in the patients with insomnia (AHR=1.73; 95% CI: 1.57-1.90), patients with parasomnia (AHR=2.76; 95% CI: 1.53-5.00), and patients with OSA (AHR=2.10; 95% CI: 1.16-3.80). Moreover, patients with parasomnia had significantly higher risk of developing oral cancer (AHR=2.71; 95% CI: 1.02-7.24) compared with patients without parasomnia. The risk of suffering from nasal cancer (AHR=5.96, 95% CI: 2.96-11.99) and prostate cancer (AHR=3.69, 95% CI: 1.98- 6.89) in patients with OSA was significantly higher than that of patients without OSA.Conclusions: Our findings provided the evidence that people diagnosed with insomnia, parasomnia and OSA are at a higher risk of developing cancers to remind people to improve sleep quality.

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“…Focal lesions of the pontine tegmentum region, such as stroke, demyelination and malignancy have been associated with RBD. 2,[12][13][14] Volumetric studies in patients with RBD in PD have also suggested a strong role of this specific area in the pathogenesis of RBD, with smaller volumes in the pontomesencephalic tegmentum, as well as the medullary reticular formation, hypothalamus, thalamus, putamen, amygdala, and anterior cingulate cortex. 15 In our case, immunostaining for tau revealed neuronal loss and tau-positive inclusions exactly in the principle areas of interest in the pontomesencephalic tegmentum.…”

Section: Discussionmentioning

confidence: 99%

Dream Enactment Behavior Disorder Associated with Pallido‐Nigro‐Luysian Degeneration and Tau Proteinopathy

Luca

Slow

Martínez-Valbuena

et al. 2021

Movement Disord Clin Pract

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BackgroundBackground: Pallido-nigro-luysian atrophy (PNLA) is a rare neurodegenerative disorder with only a few cases reported to date. Although the clinical picture usually resembles progressive supranuclear palsy, pathological examination reveals more selective atrophy and loss of neurons in the globus pallidus, substantia nigra and subthalamic nucleus. Objectives Objectives: To describe the clinical features and pathological findings of a patient with PNLA. Methods Methods: Case report with clinico-pathological discussion. ResultsResults: An 83-year-old man presented to our clinic with a vertical supranuclear gaze palsy, parkinsonism, gait impairment and sleep abnormalities suggestive of REM-sleep behavior disorder. Neuropathological examination 5 years after symptom onset revealed subcortical tau proteinopathy compatible with a PNLA pattern. There was also an associated mild degree of limbic/subcortical inflammatory response, Alzheimer's disease-related changes, as well as argyrophilic grain disease. Conclusions Conclusions: We present a comprehensive clinico-pathological discussion of a patient with PNLA. Besides parkinsonism and vertical supranuclear gaze palsy, the patient also had a sleep disorder, clinically suggestive of REM behavioral disorder, which has not been previously reported in PNLA. We expand the clinical phenotype of this rare condition and provide neuropathological evidence for the associated abnormalities.Pallido-nigro-luysian atrophy (PNLA) is a rare neurodegenerative disorder characterized by selective atrophy and loss of neurons in the globus pallidus, substantia nigra and subthalamic nucleus. 1 To date, very few cases have characterized the clinical spectrum of this condition, which may affect up to 2% of all patients with an ante-mortem diagnosis of progressive supranuclear palsy (PSP). 2 Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia defined by dream-enactment behaviors during REM sleep. Although RBD can occur in a variety of neurological conditions, it is strongly linked to neurodegenerative diseases associated with α-synuclein pathology (ie α-synucleinopathies), such as Parkinson's disease (PD), dementia with Lewy bodies, and multiple system atrophy. 3 Clinical CaseAn 83-year-old man with a history of hypertension, dyslipidemia, osteoarthritis and chronic back pain presented to our Movement Disorders Clinic for evaluation of gait imbalance. His initial symptoms started around 4 years earlier, shortly after a bilateral hip replacement surgery. At the time, he developed progressive unsteadiness and frequent falls with a 3-year history of slowness of movements and rest tremors. For 1-2 years he had also demonstrated dream enactment motor activity during sleep, associated with excessive kicking and slapping. Visual hallucinations and fluctuation of cognitive functions were not reported. More recently he developed dysphagia with occasional choking

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Rapid Eye Movement Sleep Behavior Disorder in a Patient with Brainstem Lymphoma

Cited by 25 publications

References 24 publications

A Neurologist's Guide to REM Sleep Behavior Disorder

A Neurologist's Guide to REM Sleep Behavior Disorder

Risk of Cancer in Patients with Insomnia, Parasomnia, and Obstructive Sleep Apnea: A Nationwide Nested Case-Control Study

Dream Enactment Behavior Disorder Associated with Pallido‐Nigro‐Luysian Degeneration and Tau Proteinopathy

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