title: Differential diagnosis of sporadic adult-onset ataxia: The role of REM sleep behavior disorder.
abstract: BACKGROUND
  Sporadic adult-onset ataxia encompasses a group of degenerative, non-hereditary disorders, including idiopathic adult-onset ataxia and the cerebellar form of multiple system atrophy. Our objective was to analyze the diagnosis at follow-up of 50 sporadic adult-onset ataxia patients.
  
  
  METHODS
  Clinical and laboratory findings of 50 adult patients with sporadic adult-onset ataxia were analyzed. Diagnosis of probable REM sleep behavior disorder was based predominantly on clinically accepted criteria.
  
  
  RESULTS
  Multiple system atrophy was diagnosed in 48% of cases, the remaining 52% received a diagnosis of sporadic adult-onset ataxia. REM sleep behavior disorder was diagnosed in 46% of the patients. However, among patients with probable multiple system atrophy, the corresponding figure was 83.34% versus 11.53% among those with sporadic ataxia (p < 0.001).
  
  
  CONCLUSIONS
  REM sleep behavior disorder is an important aid to the differentiation of multiple system atrophy from sporadic adult-onset ataxia and its use for this purpose should be encouraged.
authors.affiliation: Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil. Electronic address: hagteive@mps.com.br.
authors.forename: Hélio A G
authors.initials: HA
authors.lastname: Teive
authors.affiliation: Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Walter O
authors.initials: WO
authors.lastname: Arruda
authors.affiliation: Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Moro
authors.affiliation: Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Mariana
authors.initials: M
authors.lastname: Moscovich
authors.affiliation: Movement Disorders Centre, Toronto Western Hospital, University of Toronto, Toronto, Canada.
authors.forename: Renato P
authors.initials: RP
authors.lastname: Munhoz
mesh_terms: D000328:Adult; D017668:Age of Onset; D001259:Ataxia / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis* / Q000453:epidemiology; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis* / Q000453:epidemiology
keywords: Idiopathic late onset ataxia; Multiple system atrophy; Sporadic adult-onset ataxia