1/4. Rapid eye movement sleep behaviour disorder, depression and cognitive impairment. Case study.BACKGROUND: Rapid eye movement (REM) sleep behaviour disorder is a relatively new diagnostic category. It has never before been associated with a treatable depressive condition. AIMS: To report on a 74-year-old man with a history of depression and REM sleep behaviour disorder, associated with mild cognitive impairment. METHOD: Assessment using brain CT, MRI, PET, electroencephalography, neuropsychological testing and nocturnal polysomnography. RESULTS: depression was treated with sertraline. sleep laboratory studies supported a diagnosis of REM sleep behaviour disorder, which was treated with clonazepam. sleep apnoea, revealed later, was treated with nasal continuous positive airways pressure. brain MRI showed mild atrophy, but neuropsychological testing indicated no progressive cognitive deterioration. CONCLUSIONS: This case draws attention to REM sleep behaviour disorder and its potential interaction with depression and cognitive impairment, producing symptoms which can be mistaken for early dementia. The diagnosis of REM sleep behaviour disorder is easily missed, and it requires careful history-taking and sleep investigation in all suspected sufferers. Associated neurological, sleep and psychiatric conditions (including depression and cognitive impairment) may confound the diagnosis.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/4. Homozygous machado-joseph disease presenting as REM sleep behaviour disorder and prominent psychiatric symptoms.A male patient carrying the homozygous gene for machado-joseph disease (MJD) presented at age 43 with sleep disturbances and psychiatric symptoms followed by ataxic speech and gait. A polysomnogram (PSG) showed decreased rates of sleep time and stage rapid eye movement (REM) and an increased rate of 'stage 1-REM with tonic EMG' (Tachibana et al., 1975); all compatible with REM sleep behaviour disorder (RBD). Molecular gene analysis at age 59 showed that the CAG repeat units in the MJD gene were 60 and 60, smaller than the reported lengths for homozygous MJD patients (63-70 and 66-72). In addition to sleep disturbances, in particular RBD, psychiatric symptoms may be important clinical features in both heterozygous and homozygous MJD.- - - - - - - - - - ranking = 0.55555555555556keywords = behaviour (Clic here for more details about this article) |
3/4. Falling asleep.We describe a 74-year-old woman who presented with a history of falling from bed in association with vivid dreams and physical violence towards her spouse. A clinical diagnosis of rapid eye movement sleep behaviour disorder was made and complete resolution of her symptoms was achieved with first line treatment.- - - - - - - - - - ranking = 0.11111111111111keywords = behaviour (Clic here for more details about this article) |
4/4. REM sleep behaviour disorder in a child with Tourette's syndrome.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 study. RESULTS: The co-existence of Tourette'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.- - - - - - - - - - ranking = 0.55555555555556keywords = behaviour (Clic here for more details about this article) |