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Parasomnia overlap disorder with adolescent-onset presumed REM sleep behavior disorder converting to Parkinson's disease after 48 years

Lookup NU author(s): Dr Zheyu Xu, Dr Kirstie Anderson


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© 2019 Elsevier B.V. Background: 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. Patient: 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. Results: 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. Conclusions: 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.

Publication metadata

Author(s): Xu Z, Oliver JR, Anderson KN

Publication type: Article

Publication status: Published

Journal: Sleep Medicine

Year: 2019

Volume: 57

Pages: 97-99

Print publication date: 01/05/2019

Online publication date: 12/02/2019

Acceptance date: 31/01/2019

ISSN (print): 1389-9457

ISSN (electronic): 1878-5506

Publisher: Elsevier BV


DOI: 10.1016/j.sleep.2019.01.041


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