REM sleep behavior disorder: relevance to epileptologists

BackgroundRapid eye movement (REM) sleep behavior disorder (RBD) is aparasomnia 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.ObjectiveOur aim was to provide arelevant update on RBD for electroencephalography (EEG) and epilepsy specialists.MethodsThis study comprised afocused literature review.ResultsTypical 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 acommon 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.ConclusionRBD comprises afascinating, 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.