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Differential Diagnosis and Related Disorders: RBD Mimics

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Rapid-Eye-Movement Sleep Behavior Disorder

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Abstract

A wide range of motor-behavioral sleep-related events may simulate RBD episodes, leading to RBD misdiagnosis. RBD mimics include arousalrelated motor manifestations in severe obstructive sleep apnea, disorders of arousal from NREM sleep, sleep-related movement disorders, temporal and frontal nocturnal epileptic seizures, insulinoma-related hypoglycemia and psychogenic disorders. Distinguishing RBD from its mimics may be challenging and even more difficult in cases of comorbidity of RBD with its mimics and in the context of synucleinopathies. In fact, NREM arousal-related episodes clinically indistinguishable from RBD were reported to occur in subjects with PD, Parkinson’s disease dementia, and dementia with Lewy bodies. A correct diagnosis of RBD is of great importance because a misdiagnosis may carry noteworthy clinical, ethical, and even forensic consequences. Several clinical parameters can help distinguish true RBD, but only video-PSG can lead to a conclusive diagnosis. In case of suspicion of epileptic seizures, V-PSG with extended EEG montages is recommended.

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Authors and Affiliations

  1. Sleep Medicine and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy

    Raffaele Manni & Michele Terzaghi

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  1. Raffaele Manni
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  2. Michele Terzaghi
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Correspondence to Raffaele Manni .

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Editors and Affiliations

  1. Minnesota Regional Sleep Disorders Center, Departments of Psychiatry, University of Minnesota Medical School and Hennepin County Medical Center, Minneapolis, MN, USA

    Carlos H. Schenck

  2. Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    Birgit Högl

  3. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Aleksandar Videnovic

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Manni, R., Terzaghi, M. (2019). Differential Diagnosis and Related Disorders: RBD Mimics. In: Schenck, C., Högl, B., Videnovic, A. (eds) Rapid-Eye-Movement Sleep Behavior Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-90152-7_26

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  • DOI: https://doi.org/10.1007/978-3-319-90152-7_26

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