Tan A, Salgado M, Fahn S
Department of Neurology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Mov Disord. 1996 Mar;11(2):214-6. doi: 10.1002/mds.870110216.
Rapid eye movement (REM) sleep behavior disorder (RBD) involves complex behavior and a loss of muscle atonia occurring during REM sleep. Half of these patients with RBD have an underlying neurologic disorder including dementia, olivopontocerebellar atrophy, subarachnoid hemorrhage, and cerebrovascular disease. Clonazepam is the drug of choice for RBD. RBD has been rarely reported to precede the onset of Parkinson's disease (PD). Three patients are presented here whose RBD preceded the onset of PD by several years, and both the symptoms of PD and RBD improved with levodopa treatment. It is postulated that levodopa ameliorates RBD by suppressing REM sleep, and it remains to be seen whether levodopa can be an alternative to clonazepam in idiopathic RBD without PD.
快速眼动（REM）睡眠行为障碍（RBD）涉及快速眼动睡眠期间出现的复杂行为和肌肉张力缺失。这些RBD患者中有一半患有潜在的神经系统疾病，包括痴呆、橄榄脑桥小脑萎缩、蛛网膜下腔出血和脑血管疾病。氯硝西泮是RBD的首选药物。很少有报道称RBD先于帕金森病（PD）发作。本文介绍了3例患者，他们的RBD在PD发作前数年出现，左旋多巴治疗使PD和RBD的症状均得到改善。据推测，左旋多巴通过抑制快速眼动睡眠来改善RBD，在无PD的特发性RBD中，左旋多巴能否替代氯硝西泮还有待观察。
