Parasomnia as an occasion for the diagnosis of Parkinson's disease.
We report a case of Parkinson's disease (PD) diagnosed by REM sleep behavior disorder (RBD). The patient was a 68-year-old man. On admission, rigidity in the left upper and lower extremities, bradykinesia, and gait disturbance were noted. In addition, polysomnography revealed REM sleep without atonia (RWA), and a diagnosis of untreated PD associated with RBD was made. Polysomnographic data showed that REM density decreased and RWA tended to increase after administration of a combination of L-DOPA and DCI (L-DOPA/DCI). Thus, we considered that the pathophysiological mechanism of RBD in this case was based not only on the dysfunction of the brainstem mechanism of RWA, but also on the impairment of dopaminergic neuron.
Miyamoto
M
M
Department of Neurology, Dokkyo University School of Medicine, Tochigi, Japan. miyamasa@dokkyomed.ac.jp
Miyamoto
T
T
Takekawa
H
H
Kubo
J
J
Hirata
K
K
D000368:Aged; D001933:Brain Stem / Q000378:metabolism / Q000503:physiopathology; D004298:Dopamine / Q000378:metabolism; D006801:Humans; D008297:Male; D009474:Neurons / Q000378:metabolism; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000150:complications* / Q000175:diagnosis*; D012720:Severity of Illness Index
D004298:Dopamine