In 1986, Schenck and coworkers described REM-sleep behavior disorder as a treatable parasomnia affecting older males. This disorder is characterized by intermittent loss of the muscle atonia, which normally characterizes the rapid eye movement (REM) sleep state. Complex motor behaviors occur that are often injurious and are associated with dreaming. We have identified five children who meet the criteria for REM-sleep behavior disorder and describe the clinical and polysomnographic characteristics of these patients, along with corresponding polysomnographic characteristics of matched comparison subjects. (J Child Neurol 1998; 13:257-260).
Get full access to this article
View all access options for this article.
References
1.
Schenck CH, Bundlie SR, Ettinger MG, et al: Chronic behavioral disorders of human REM sleep: A new category of parasomnia. Sleep1986;9:293-308.
2.
American Sleep Disorders Association: The International Classification of Sleep Disorders: Diagnostic and Coding Manual. Lawrence, KS, Allen Press , 1990, pp 177-180.
3.
Mahowald MW, Schenck CH: REM sleep behavior disorder, in Kryger MH, Roth T, Dement WC (eds): Principles and Practice of Sleep Medicine. Philadelphia, WB Saunders, 1989, pp 389-401.
4.
Culebras A., Moore JT: Magnetic resonance findings in REM sleep behavior disorder. Neurology1989;39:1519-1523.
5.
Schenck CH, Mahowald MW: A polysomnographic, neurologic, psychiatric, and clinical outcome report on 70 consecutive cases with REM sleep behavior disorder (RBD): Sustained clonazepam efficacy in 89.5% of 57 treated patients. Clev Clin J Med1990; 57(Suppl):9-23.
6.
Schenck CH, Mahowald MW: Motor dyscontrol in narcolepsy: Rapid-eye-movement (REM) sleep without atonia and REM sleep behavior disorder. Ann Neurol1992;32:3-10.
7.
Barros-Ferreira M., Chodkiewicz J-P., Lairy GC, Salzarulo P.: Disorganized relations of tonic and phasic events of REM sleep in a case of brain-stem tumour. Electroencephalogr Clin Neurophysiol1975;38:203-207.
8.
Herman JH, Blaw ME, Steinberg JB: REM behavior disorder in a two year old male with evidence of brainstem pathology . Sleep Res1989;18:242.
9.
Blaw ME, Leroy RF, Steinber JB, Herman J.: Hereditary quivering chin and REM behavioral disorder. Ann Neurol1989;26:471.
10.
Schenck CH, Bundlie SR, Smith AS, et al: REM behavior disorder in a 10 year old girl and aperiodic REM and NREM sleep movements in an 8 year old brother. Sleep Res1986;15:162.
11.
Rechtschaffen A., Kales AA: A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. Bethesda, MD, National Institute of Neurological Disease and Blindness, 1968.
12.
Hendricks JC , Morrison AR, Mann GL: Different behaviors during paradoxical sleep without atonia depend on pontine lesion site. Brain Res1982;239:81-105.
13.
Jouvet M., Delorme F.: Locus Coeruleus et sommeil paradoxal. C R Soc Biol (Paris) 1965;159:895-899.
14.
Hishikawa Y. , Sugita Y., Iijima S., et al: Mechanisms producing "stage 1-REM" and similar dissociations of REM sleep and their relation to delerium. Shinkei Kenkyu no Shimpo [Adv Neurol Sci] (Tokyo) 1981;25:1129-1147.
15.
Ross RJ, Ball WA, Dinges DF, et al: Motor dysfunction during sleep in post-traumatic stress disorder . Sleep1994;17:723-732.
16.
Ross RJ, Ball WA, Dinges DF, et al: Rapid eye movement sleep disturbance in post-traumatic stress disorder. Biol Psychiatry1994;35:195-202.
17.
Mellman TA, Kulick-Bell R., Aslock LE, Nolan B.: Sleep events among veterans with combat-related post-traumatic stress disorder . Am J Psychiatry1995;152:110-115.
18.
Schenck CH, Mahowald MW: Injurious sleep behavior disorders (parasomnias) affecting patients on intensive care units. Intensive Care Med1991;17:219-224.
19.
Chadwick D. , Hallet M., Harris R., et al: Clinical, biochemical and physiological features distinguishing myoclonus responsive to 5-hydroxytryptophan, tryptophan with a monoamine oxidase inhibitor and clonazepam. Brain1977;100:455-487.
20.
Green RA, Gillin JC, Wyatt RJ: The inhibitory effect of intraventricular administration of serotonin on spontaneous motor activity of rats. Psychopharmacology1976;51:81-84.
21.
Hollister AS , Breese GR, Kuhn CM, et al: An inhibitory role for brain serotonin-containing systems in the locomotor effects of D-amphetamine . J Pharmacol Exp Ther1976;198:12-22.
22.
Mahowald MW, Schenck CH: REM sleep behavior disorder, in Kryger MH, Roth T, Dement WC (eds): Principles and Practice of Sleep Medicine, 2nd ed. Philadelphia, WB Saunders, 1994, pp 574-588.
