title: Status dissociatus evolving from REM sleep behaviour disorder in multiple system atrophy.
abstract: OBJECTIVE
  We present two patients, a 52-year-old man and a 56-year-old woman, with rapid eye movement sleep behaviour disorder (RBD) since the age of 50.
  
  
  METHODS
  In both the patients RBD was videopolysomnographically documented.
  
  
  RESULTS
  Both patients developed, with time, autonomic and motor symptoms consistent with the diagnosis of multiple system atrophy. During the course of the disease RBD episodes diminished in frequency but the patients' sleep became even more abnormal, with nearly continuous motor and verbal abnormal behaviours and ambiguous and rapid oscillations of state-determining polysomnographic variables, now consistent with status dissociatus (SD).
  
  
  CONCLUSIONS
  If SD represents the evolution and most extreme form of RBD it should be investigated longitudinally in neurodegenerative diseases.
authors.affiliation: Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy. vetrugno@neuro.unibo.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Vetrugno
authors.forename: Maria
authors.initials: M
authors.lastname: Alessandria
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Angelo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
authors.forename: Federica
authors.initials: F
authors.lastname: Provini
authors.forename: Pietro
authors.initials: P
authors.lastname: Cortelli
authors.forename: Pasquale
authors.initials: P
authors.lastname: Montagna
mesh_terms: D004213:Dissociative Disorders / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D014741:Video Recording