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Zeitschrift für Epileptologie

, Volume 32, Issue 1, pp 6–11 | Cite as

REM sleep behavior disorder: relevance to epileptologists

  • Carlos H. SchenckEmail author
Leitthema
  • 32 Downloads

Abstract

Background

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia that features loss of the generalized skeletal muscle atonia of mammalian REM sleep, with release of injurious dream-enacting behaviors. Video-polysomnography is necessary to confirm the diagnosis.

Objective

Our aim was to provide a relevant update on RBD for electroencephalography (EEG) and epilepsy specialists.

Methods

This study comprised a focused literature review.

Results

Typical and atypical RBD clinical profiles are presented and discussed. Official diagnostic criteria are listed and experimental animal models are reviewed. The differential diagnosis, including nocturnal seizures, is considered, and EEG, evoked potential, and sleep spindle findings are presented. Emphasis is placed on idiopathic RBD as a common herald of future alpha-synucleinopathy neurodegeneration (Parkinson’s disease, dementia with Lewy bodies, multiple system atrophy). Furthermore, we describe the formation of the International RBD Study Group in 2009 with yearly research symposia.

Conclusion

RBD comprises a fascinating, multidimensional parasomnia that needs to be considered in the differential diagnosis of nocturnal epilepsy with abnormal sleep-related behaviors in order to facilitate identifying the correct diagnosis and to initiate proper therapy.

Keywords

REM sleep parasomnia Nocturnal epilepsy Electroencephalography Polysomnography REM atonia 

REM-Schlaf-Verhaltensstörung: Bedeutung für Epileptologen

Zusammenfassung

Hintergrund

Die REM-Schlaf-Verhaltensstörung („rapid eye movement sleep behavior disorder“, RBD) stellt eine Parasomnie dar, die gekennzeichnet ist durch den Verlust der generalisierten Skelettmuskelatonie im REM-Schlaf bei Säugetieren, mit Freisetzung selbst- oder fremdgefährdender Verhaltensweisen im Rahmen des Ausagierens von Trauminhalten. Zur Diagnosesicherung ist eine Videopolysomnographie erforderlich.

Ziel

Ziel der Arbeit war es, Epileptologen und Neurologen einen Überblick über den aktuellen Wissenstand zur RBD zu geben.

Methoden

Die vorliegende Studie umfasst eine fokussierte Literaturübersicht.

Ergebnisse

Es werden typische und atypische klinische Profile der RBD vorgestellt und erörtert. Dabei werden die offiziellen Diagnosekriterien aufgeführt und experimentelle Tiermodelle dargestellt. Differenzialdiagnosen einschließlich nächtlicher Anfälle werden betrachtet und EEG, evozierte Potenziale und Schlafspindelbefunde präsentiert. Im Vordergrund steht die idiopathische RBD als üblicher Vorbote einer Neurodegeneration im Rahmen einer Alpha-Synukleinopathie (M. Parkinson, Lewy-Körperchen-Demenz, Multisystematrophie). Darüber hinaus wird die Entstehung einer internationalen RBD-Arbeitsgruppe (International RBD Study Group) im Jahr 2009 mit jährlichen Forschungssymposien beschrieben.

Schlussfolgerung

Die RBD bezeichnet eine faszinierende multidimensionale Parasomnie, die miteinbezogen werden muss in die Differenzialdiagnose schlafgebundener abnormer Verhaltensweisen, und die abgegrenzt werden muss gegen schlaf-assoziierte epileptische Anfälle, um dann – nach korrekter Diagnosestellung – eine adäquate Therapie zu ermöglichen.

Schlüsselwörter

REM-Schlaf-Parasomnie Nächtliche Epilepsie Elektroenzephalographie Polysomnographie REM-Atonie 

Notes

Compliance with ethical guidelines

Conflict of interest

C.H. Schenck is a consultant for Axovant Sciences, Inc., which has no bearing on the contents of this manuscript.

This article does not contain any studies with human participants or animals performed by any of the authors. For images or other information within the manuscript which identify patients, consent was obtained from them and/or their legal guardians.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Psychiatry, Minnesota Regional Sleep Disorders Center, Hennepin County Medical CenterUniversity of Minnesota Medical SchoolMinneapolisUSA

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