Differential diagnosis of sporadic adult-onset ataxia: The role of REM sleep behavior disorder

Background: Sporadic adult-onset ataxia encompasses a group of degenerative, non-hereditary disorders, including idiopathic adult-onset ataxia and the cerebellar form of multiple system atrophy. Our objective was to analyze the diagnosis at follow-up of 50 sporadic adult-onset ataxia patients. Methods: Clinical and laboratory findings of 50 adult patients with sporadic adult-onset ataxia were analyzed. Diagnosis of probable REM sleep behavior' disorder was based predominantly on clinically accepted criteria. Results: Multiple system atrophy was diagnosed in 48% of cases, the remaining 52% received a diagnosis of sporadic adult-onset ataxia. REM sleep behavior disorder was diagnosed in 46% of the patients. However, among patients with probable multiple system atrophy, the corresponding figure was 83.34% versus 11.53% among those with sporadic ataxia (p < 0.001). Conclusions: REM sleep behavior disorder is an important aid to the differentiation of multiple system atrophy from sporadic adult-onset ataxia and its use for this purpose should be encouraged. (C) 2015 Elsevier Ltd. All rights reserved.