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September 26, 2000; 55 (6) Clinical/Scientific Notes

A discrete pontine ischemic lesion could cause REM sleep behavior disorder

K. Kimura, N. Tachibana, J. Kohyama, Y. Otsuka, S. Fukazawa, R. Waki
First published September 26, 2000, DOI: https://doi.org/10.1212/WNL.55.6.894
K. Kimura
From the Departments of Neurology (Drs. Kimura, Otsuka, and Waki) and Neurosurgery (Dr. Fukazawa), Shizuoka City Hospital, Shizuoka; Osaka Kaisei Hospital Sleep Medical Center (Dr. Tachibana); Department of Pediatrics (Dr. Kohyama), Faculty of Medicine, Tokyo Medical and Dental University, Japan.
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N. Tachibana
From the Departments of Neurology (Drs. Kimura, Otsuka, and Waki) and Neurosurgery (Dr. Fukazawa), Shizuoka City Hospital, Shizuoka; Osaka Kaisei Hospital Sleep Medical Center (Dr. Tachibana); Department of Pediatrics (Dr. Kohyama), Faculty of Medicine, Tokyo Medical and Dental University, Japan.
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J. Kohyama
From the Departments of Neurology (Drs. Kimura, Otsuka, and Waki) and Neurosurgery (Dr. Fukazawa), Shizuoka City Hospital, Shizuoka; Osaka Kaisei Hospital Sleep Medical Center (Dr. Tachibana); Department of Pediatrics (Dr. Kohyama), Faculty of Medicine, Tokyo Medical and Dental University, Japan.
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Y. Otsuka
From the Departments of Neurology (Drs. Kimura, Otsuka, and Waki) and Neurosurgery (Dr. Fukazawa), Shizuoka City Hospital, Shizuoka; Osaka Kaisei Hospital Sleep Medical Center (Dr. Tachibana); Department of Pediatrics (Dr. Kohyama), Faculty of Medicine, Tokyo Medical and Dental University, Japan.
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S. Fukazawa
From the Departments of Neurology (Drs. Kimura, Otsuka, and Waki) and Neurosurgery (Dr. Fukazawa), Shizuoka City Hospital, Shizuoka; Osaka Kaisei Hospital Sleep Medical Center (Dr. Tachibana); Department of Pediatrics (Dr. Kohyama), Faculty of Medicine, Tokyo Medical and Dental University, Japan.
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R. Waki
From the Departments of Neurology (Drs. Kimura, Otsuka, and Waki) and Neurosurgery (Dr. Fukazawa), Shizuoka City Hospital, Shizuoka; Osaka Kaisei Hospital Sleep Medical Center (Dr. Tachibana); Department of Pediatrics (Dr. Kohyama), Faculty of Medicine, Tokyo Medical and Dental University, Japan.
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Citation
A discrete pontine ischemic lesion could cause REM sleep behavior disorder
K. Kimura, N. Tachibana, J. Kohyama, Y. Otsuka, S. Fukazawa, R. Waki
Neurology Sep 2000, 55 (6) 894-895; DOI: 10.1212/WNL.55.6.894

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This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

REM sleep behavior disorder (RBD) is characterized by lack of atonia of major muscle groups during REM sleep associated with excessive movement related to dreaming.1 Various neurodegenerative diseases involving brainstem structures have been reported to be associated with RBD.2 We report a patient with RBD with the sole lesion in the pontine reticular formation that could cause the abnormality of REM-mediated muscle atonia.

Case report.

A 75-year-old woman was admitted to our hospital complaining of frequent episodes of transient dizziness and abnormal nocturnal behavior. This behavior started about 10 years before, when she also had a TIA manifesting as transient weakness in the right upper and lower extremities. She had a 9-year history of diabetes mellitus and hypertension, both of which were well controlled on diet and exercise therapy. Her nocturnal behavior was characterized by waving her arms, beating herself at the wall, and kicking the bedclothes. During these episodes, she often shouted because she became angry with employees of her company in her …

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