RBD, Rapid Eye Movement Sleep Behavior Disoder

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Clinic

  • RBD is a parasomnia, A sleep disorder in which people act out their dreams. It involves abnormal behavior during REM sleep.
  • The major feature of RBD is loss of muscle atonia during otherwise intact REM sleep.
  • Loss of motor inhibition leads to sleep behaviors ranging from simple limb twitches to more complex integrated movements
  • RBD is a very strong predictor of progression to Parkinson's disease or dementia with Lewy bodies


Main symptoms

  • RBD is characterized by the dreamer acting out their dreams, with complex behaviors.
  • Dreams often involve Violent / Aggressive actions such as Screaming, Shouting, Laughing, Crying, Arm flailing, Kicking, Punching, Choking, and Jumping
  • The sleeping person may be unaware of these movements.


Other symptoms

TBE HSV-1 JE HSV-2
Seizure +++ +++ +++ +++
Hallucination +++ +++ +++ +++
Delusion +++ +++ +++ +++
Delirium +++ +++ +++ +++
Orthostatic hypotension +++ +++
Constipation +++ +++
Urinary in continence +++
Dilated pupils +++
Anosmia +++ +++
Cerebral achromatopsia

Related disease


Causes

  • Loss of normal voluntary muscle atonia during REM sleep results in motor behavior in response to dream content
  • Brainstem circuits (Pontomedullary brainstem) that control atonia during REM sleep may be damaged.
  • REM sleep circuits are located in caudal brainstem structures are the same structures that are implicated in the synucleinopathies.
    • Motor deficits like those seen in RBD are known to result from lesions in those circuits.


Differential Diagnosis


Entities / Miasms

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