Status dissociatus evolving from REM sleep behaviour disorder in multiple system atrophy.
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.
Vetrugno
Roberto
R
Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy. vetrugno@neuro.unibo.it
Alessandria
Maria
M
D'Angelo
Roberto
R
Plazzi
Giuseppe
G
Provini
Federica
F
Cortelli
Pietro
P
Montagna
Pasquale
P
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