Rapid-eye-movement sleep behavior disorder secondary to acute aseptic limbic encephalitis

Lin, Feng-Cheng; Liu, Ching-Kuan; Hsu, Chung‐Yao

doi:10.1007/s00415-009-5067-9

Cited by 28 publications

(16 citation statements)

References 14 publications

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“…Previous imaging studies have shown that, during REM sleep, regional cerebral blood flow is significantly increased in the pontine tegmentum, thalamic nuclei and limbic areas (26,27). This interaction within the limbic system is activated during REM sleep, suggesting that limbic system impairment may be implicated in the pathogenesis of RBD (24).…”

Section: Discussionmentioning

confidence: 91%

“…Interestingly, RBD has also been reported to occur in association with damage in the limbic system without primary brainstem impairment (23)(24)(25). Previous imaging studies have shown that, during REM sleep, regional cerebral blood flow is significantly increased in the pontine tegmentum, thalamic nuclei and limbic areas (26,27).…”

Section: Discussionmentioning

confidence: 99%

“…It is thought that excessive electromyographic (EMG) activity during REM sleep in RBD patients reflects dysfunction of the brainstem structures responsible for muscle atonia during REM sleep (2)(3)(4)(5). RBD is very common in several neurodegenerative diseases, including multiple system atrophy, dementia with Lewy bodies and Parkinson's disease (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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Rapid eye movement (REM) sleep behavior disorder (RBD) is common in patients with neurodegenerative diseases. RBD occurring in a patient with brainstem lymphoma has not yet been reported. A 30-year-old man had an eleven-month history of violent motor and vocal behavior during sleep. Brain magnetic resonance imaging disclosed hypointensity T1 and hyperintensity T2 signals in the pontomesencephalic junction and at the upper/mid pons level. A stereotactic biopsy demonstrated the presence of diffuse large B-cell lymphoma. On polysomnography, there was enhanced submental and limb electromyographic tone and increased muscular activity during REM sleep. Chemotherapy diminished the dream-enacting behaviors. This case provides evidence that treatment aimed at the primary disease can partially improve the frequency of RBD.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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“…Dream enactment resolved in three of four patients treated with immunotherapy, although follow up vPSG data are not available to assess whether RWA also resolved. Additional cases of autoimmune or inflammatory encephalitis causing RBD include anti-Ma2 paraneoplastic syndrome [54] and one case of aseptic limbic encephalitis of unknown etiology [55]. All of these cases, except the last, were in individuals over age 50, reflecting the demographics of these specific types of usually paraneoplastic encephalites.…”

Section: Inflammatory and Autoimmune Conditionsmentioning

confidence: 99%

Rapid eye movement sleep behavior disorder in adults younger than 50 years of age

Ju¹

2013

Sleep Medicine

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Rapid eye movement (REM) sleep behavior disorder (RBD) occurring prior to age 50 is termed early-onset RBD. Early-onset RBD comprises a substantial minority of cases, and demonstrates the differences in demographics, comorbidities, and clinical considerations from previously described typical RBD with onset >50 years. The world literature on RBD is reviewed with specific focus on features that distinguish early-onset RBD, including more gender parity, increased proportion of idiopathic cases, increased proportion of cases associated with narcolepsy, parasomnia overlap disorder, antidepressants, and possibly autoimmune disorders, and clinical presentation.

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“…Limbic encephalitis, either due to voltage-gated potassium channel antibodies in a small series[81] or due to non-antibody-mediated aseptic encephalitis in a single case[82], has been associated with RBD. In over half of the patients with voltage-gated potassium channel antibodies, RBD resolved after successful immunotherapy.…”

Section: Rbd Co-morbiditiesmentioning

confidence: 99%

REM Sleep Behaviour Disorder in Older Individuals

Trotti

2010

Drugs & Aging

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Rapid eye movement (REM) sleep behavior disorder (RBD) is a sleep disorder that predominantly affects older adults, in which patients appear to be enacting their dreams while in REM sleep. The behaviors are typically violent, in association with violent dream content, so serious harm can be done to the patient or the bed-partner. The estimated prevalence in adults is 0.4-0.5%, but the frequency is much higher in certain neurodegenerative diseases, especially Parkinson's disease, Dementia with Lewy bodies, and multiple systems atrophy. RBD can occur in the absence of diagnosed neurologic diseases (the "idiopathic" form), although patients with this form of RBD may have subtle neurologic abnormalities and often ultimately develop a neurodegenerative disorder. Animal models and cases of RBD developing after brainstem lesions (pontine tegmentum, medulla) have led to the understanding that RBD is caused by a lack of normal REM muscle atonia and a lack of normal suppression of locomotor generators during REM. Clonazepam is used as first-line therapy for RBD and melatonin for second-line therapy, although evidence for both of these interventions comes from uncontrolled case series. Because the risk of injury to the patient or the bed-partner is high, interventions to improve the safety of the sleep environment are also often necessary. This review describes the epidemiology, pathophysiology, and treatment of RBD.

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Rapid-eye-movement sleep behavior disorder secondary to acute aseptic limbic encephalitis

Cited by 28 publications

References 14 publications

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

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

Rapid eye movement sleep behavior disorder in adults younger than 50 years of age

REM Sleep Behaviour Disorder in Older Individuals

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