title: Progressive dementia and hypersomnolence with dream-enacting behavior: oneiric dementia.
abstract: BACKGROUND
  Sleep disorders are associated with several types of degenerative dementias, including Alzheimer and prion diseases. Animal models have demonstrated abolition of rapid eye movement atonia, resulting in dream-enacting complex movements termed oneiric behavior, and patients with fatal familial insomnia may have vivid dreams that intrude on wakefulness.
  
  
  OBJECTIVE
  To describe a new form of progressive dementia with hypersomnia and oneiric behavior.
  
  
  METHODS
  Neuropsychological and polysomnographic studies of a middle-aged woman with a progressive dementia, excessive daytime sleepiness, and a vertical gaze palsy.
  
  
  RESULTS
  Neuropsychological testing revealed decreased verbal fluency, impaired attention and working memory, amnesia, poor recall, and bradyphrenia with hypersomnia. Polysomnography revealed a rapid eye movement behavioral disorder with complete absence of slow wave sleep. Prion protein analysis did not reveal the mutation associated with fatal familial insomnia, and other diagnostic test findings were unrevealing.
  
  
  CONCLUSIONS
  Our patient had a previously unreported syndrome of progressive dementia associated with rapid eye movement behavioral disorder and the absence of slow wave sleep.
authors.affiliation: Department of Neurology, McKnight Brain Institute at the University of Florida College of Medicine, 100 S Newell Dr, Room L3-100, Gainesville, FL 32610-0236, USA.
authors.forename: Jean E
authors.initials: JE
authors.lastname: Cibula
authors.forename: Stephan
authors.initials: S
authors.lastname: Eisenschenk
authors.forename: Michael
authors.initials: M
authors.lastname: Gold
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Eskin
authors.forename: Robin L
authors.initials: RL
authors.lastname: Gilmore
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Heilman
mesh_terms: D003704:Dementia / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000652:urine; D003937:Diagnosis, Differential; D006970:Disorders of Excessive Somnolence / Q000150:complications*; D004325:Dreams; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D017286:Polysomnography