39 years-old man with abnormal body movements during sleep

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39 years-old man with abnormal body movements during sleep Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology

Vignette 39-year old man with stereotyped episodes during sleep since childhood Rhythmic, side-to-side head and body rolling movements lasting 1-10 minutes Occur most days of the week Distressing for bed partner No daytime sleepiness Unremarkable neurological & physical examination. No history of cognitive problems or autism Loureiro et. al. © 2014 American Academy of Neurology references:

EEG during event Loureiro et. al. An EEG showing rhythmic movement artefact during an episode of rhythmic movement disorder. No interictal or ictal epileptiform abnormalities were seen during a 24-hour recording. Loureiro et. al. © 2014 American Academy of Neurology references:

Video Events in videos 1 & 2 occurred in sleep, characterized by a humming sound and repetitive, rolling head and body movements lasting 150 and 60 seconds, respectively. Brief arousal followed event 2 with ability to respond to attending nurse (not shown), while the patient continued sleeping after event 1. Loureiro et. al. © 2014 American Academy of Neurology references:

An adult patient with sleep related rhythmic movement disorder Rhythmic Movement Disorder (RMD) was previously known as Jactatio capitis nocturna (head banging) It is characterized by repetitive rocking or rhythmic movements of head, body or limbs (1) It usually occurs when falling asleep, during any sleep stage, or even during periods of relaxed wakefulness RMD is typically seen in infants and children but may persist into adulthood It can be confused with nocturnal epileptic seizures Treatment is not usually needed but clonazepam may help if required(2). References 1) American Academy of Sleep Medicine. International classification of sleep disorders, revised: Diagnostic and coding manual. Chicago, Illinois: American Academy of Sleep Medicine, 2005 (2) Jankovic SM, Sokic DV, Vojvodic NM, et al. Multiple rhythmic movement disorders in a teenage boy with excellent response to clonazepam. Mov Disord 2008;23:767-8 Loureiro et. al. © 2014 American Academy of Neurology references: