RBD, Rapid Eye Movement Sleep Behavior Disoder

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

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.

Reduced motor abilities
Posture and gait changes
Mild cognitive impairment
Alterations in the sense of smell
Impairments in color vision
Autonomic dysfunction (Orthostatic hypotension, Constipation, Urinary problems and Sexual dysfunction)
Depression


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

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.

I seems that extrapyramidal tracts are involved actively in RBD, therefore it belongs to EPS COE whose main miasms are JE, WNE, GSS, CJD and FFI
Color vision impairment (Cerebral achromatopsia) and Anosmia are useful guides which lead us to CJD

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