Department of Neurology, National Neuroscience Institute, Singapore; Newcastle Regional Sleep Service, Freeman Hospital, Newcastle upon Tyne, UK; Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
Sleep Med. 2019 May;57:97-99. doi: 10.1016/j.sleep.2019.01.041. Epub 2019 Feb 12.
It is now recognized that the vast majority of individuals with typical RBD will develop a synucleinopathy; usually 11-16 years after symptom onset. Parasomnia Overlap Disorder (POD) with adolescent-onset dream enactment behavior with phenoconversion to neurodegenerative disease after a long latency has not been previously described.
We present a case of a 65-year-old man with presumptive POD who had co-morbid childhood onset sleep walking and adolescent-onset dream enactment behavior beginning at age 17, with subsequent evolution to an increasingly troublesome REM sleep behavior disorder (RBD) at age 64 with Parkinson's Disease (PD) developing a year later.
Polysomnography performed at age 64 was consistent with a diagnosis of RBD. Dream enactment behavior preceded PD diagnosis by at least 48 years. Our case represents the youngest reported RBD case who developed PD.
We report the first case of adolescent onset, presumed RBD in the context of presumptive POD developing neurodegenerative disease. Adolescent-onset RBD may have similar prognostic implications as typical RBD, where future phenoconversion to a synucleinopathy is expected.
现在人们已经认识到，绝大多数具有典型 RBD 的个体将发展为突触核蛋白病；通常在症状出现后 11-16 年。以前没有描述过具有青少年发病的梦境行为表现且潜伏期长后出现神经退行性疾病表型转换的睡眠-觉醒障碍重叠症（POD）。
我们介绍了一个患有疑似 POD 的 65 岁男性的病例，他有共病性的儿童期起病的梦游和青少年期起病的梦境行为，始于 17 岁，随后在 64 岁时逐渐出现更为麻烦的 REM 睡眠行为障碍（RBD），一年后出现帕金森病（PD）。
该患者在 64 岁时进行的多导睡眠图检查符合 RBD 的诊断。梦境行为表现早于 PD 诊断至少 48 年。我们的病例代表了报道的最年轻的 RBD 病例，其发展为 PD。
我们报告了首例青少年起病、疑似 POD 背景下的疑似 RBD 发展为神经退行性疾病的病例。青少年起病的 RBD 可能具有与典型 RBD 相似的预后意义，预计未来会出现突触核蛋白病表型转换。
