A case of REM sleep behavior disorder, narcolepsy-cataplexy, parkinsonism, and rheumatoid arthritis.
A patient is reported in whom signs and symptoms of REM sleep behavior disorder (RBD) and narcolepsy have been associated for almost two decades with a late development of parkinsonism and rheumatoid arthritis. A 78-year-old male patient in whom RBD was first diagnosed was followed-up by clinical examination, video-polysomnography, multiple sleep latency test, cerebral magnetic resonance imaging, and dopamine transporter imaging by single-photon emission computerized tomography. The patient was found to present for almost two decades, in addition to RBD, also narcolepsy. Moreover, a late development of parkinsonism and the occurrence of rheumatoid arthritis were detected and clinically and instrumentally characterized. Patients predisposed to RBD and later parkinsonism might be susceptible to a variety of triggers that, in our patient, might have been represented by a possible latent autoimmune process leading to the development of narcolepsy with cataplexy and rheumatoid arthritis, later.
Department of Neurology I.C., Sleep Research Centre, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via C. Ruggero 73, 94018 Troina, Italy.
Filomena I I
FI
Cosentino
Institute of Neurological Sciences, National Research Council, 95126 Catania, Italy.
Angela
A
Distefano
Department of Biomedical and Neuromotor Sciences, University of Bologna and IRCCS Istituto delle Scienze Neurologiche di Bologna, 40123 Bologna, Italy.
Giuseppe
G
Plazzi
Department of Psychiatry, Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN 55415, USA.
Carlos H
CH
Schenck
Department of Neurology I.C., Sleep Research Centre, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via C. Ruggero 73, 94018 Troina, Italy.
Raffaele
0000-0001-6937-3065
R
Ferri
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009290:Narcolepsy / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D020734:Parkinsonian Disorders / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000150:complications* / Q000473:pathology / Q000503:physiopathology