Medical image of the week: REM without atonia

• Main Authors: Bartell J, Shetty S, Knox KS
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2015-03-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: polysomnogram; polysomnography; REM; rapid eye movement sleep behavior disorder; atonia; Parkinson's disease; parasomnia; RBD; treatment
• Online Access: http://www.swjpcc.com/imaging/2015/3/25/medical-image-of-the-week-rem-without-atonia.html

No abstract available. Article truncated after 150 words. A 78 year-old man with a past medical history of Parkinson’s disease (PD) presented to the sleep medicine clinic for evaluation of obstructive sleep apnea (OSA). An overnight polysomnogram (PSG) study was consistent with sleep apnea and revealed frequent leg and arm movements and sleep-talking during rapid eye movement (REM) sleep. REM sleep behavior disorder (RBD) is a parasomnia characterized by repeated episodes of abnormal behavior occurring during REM sleep (1,2). On PSG, REM sleep without atonia is seen while features of “normal REM” such as number of REM periods and REM cycling remain intact (2). RBD emerges most often in the context of alpha-synucleinopathies, and occurs in up to 60% of PD patients (3). The presence of RBD may be an important preclinical symptom prior to the onset of PD. Cases of PD with RBD are associated with a unique phenotype with an older age of onset, longer disease ...