REM Sleep Behaviour Disorder in a Child with Tourette's Syndrome

Abstract

572A number of studies have documented a variety of sleep disorders associated with To u r e t t e 's syndrome, 1 -6 i n c l u d i n g higher incidence of parasomnias, and periodic limb movement disorder 7,8 persisting both in rapid eye movement (REM) and non-REM sleep. [8][9][10][11] Some researchers also reported increased general movements in REM sleep. 12 Previously, there was no report of REM sleep behaviour disorder (RBD) in this population, and only two single case history reports existed 13,14 describing RBD in children, until our initial description of a series of pre-pubescent patients with Tourette's syndrome 15 and a report of RBD in otherwise asymptomatic children. 16 In our previous work 15 we presented a series of 16 patients with To u r e t t e 's syndrome, age 6-65 (14 males) who were referred to our clinic for a variety of sleep-related complaints, but predominantly for suspected nocturnal movement disorder (periodic leg movements in sleep (PLMS), restless legs syndrome (RLS), nocturnal tics) and parasomnic behaviour. In 12 patients we observed raised muscle activity in REM sleep, either in the form of (periodic) leg movements or attenuated tics, or (majority) as augmented phasic electromyograph (EMG) without associated movements. Three of these patients had confirmed, and two strongly possible RBD. Following the initial series of patients, further patients with the various sleep pathology were seen, including the case presented in this article. CASE HISTORYWe present a case of a seven-year-old boy with Tourette's syndrome and RBD. The patient was seen over the four-year period starting in 1998 when he was three years old. Polysomnographic (PSG) sleep assessments were done in late 1999 and mid-2002. ABSTRACT: Purpose:To describe an association of Tourette's syndrome with rapid eye movement sleep behaviour disorder (RBD) in a prepubescent boy. Methods: A four year longitudinal single-case s t u d y. R e s u l t s : The co-existence of To u r e t t e 's syndrome and RBD was confirmed after polysomnographic studies using the standard criteria. The authors propose possible overlap in the pathophysiological mechanisms underlying the two disorders. Can.

A quantitative statistical analysis of the submentalis muscle EMG amplitude during sleep in normal controls and patients with REM sleep behavior disorder

“…, 2006), amyotrophic lateral sclerosis (Thomas et al. , 2007), multiple sclerosis (Plazzi and Montagna, 2002), Tourette syndrome (Trajanovic et al. , 2004) and, finally, RBD can be induced by medications, especially the tricyclic antidepressants and serotonin‐specific reuptake inhibitors (Mahowald et al.…”

REM sleep behaviour disorder: not just a bad dream

“…To date, large clinicopathological series of RBD have found AD pathology to be rare (< 1%) 31 . RBD has also been reported in neurodevelopmental disorders such as autism 44 and Tourette syndrome, 45 as well as among a number of paraneoplastic disorders such as limbic encephalitis and cerebellar degeneration 46 . ‐ 48 RBD can also occur in the setting of discrete ischaemic, demyelinating or neoplastic lesions affecting regions of the brain (primarily brainstem pontine structures) involved in the control of REM sleep 49 , 50 …”

Rapid Eye Movement Sleep Behavior Disorder During Childhood

“…From another standpoint, static neurodevelopmental disabilities such as autism, Moebius syndrome, and Smith Magenis syndrome; structural brainstem lesions such as neoplasms or Chiari type 1 malformation; narcolepsy; juvenile Parkinson disease; and the use of psychotropic medications predominate. [10][11][12][13][14][15][16][17] The common link between RBD of childhood and that of adults is the identical final common pathway leading up to event (ie, sleep state dissociation). 18 This is a process whereby elements of wakefulness such as tonic electromyographic activity, vocalizations, and bodily movement become superimposed on the phenomena of REM sleep.…”