title: Rapid Eye Movement Sleep Behavior Disorder in Paraneoplastic Cerebellar Degeneration: Improvement with Immunotherapy.
abstract: OBJECTIVE
  To report two female patients with paraneoplastic cerebellar degeneration (PCD) related to breast cancer that presented with rapid eye movement-sleep behavior disorder (RBD) and improved sleep symptoms with immunotherapy.
  
  
  METHODS
  The two patients were evaluated through clinical scale and polysomnography before and after therapy with intravenous immunoglobulin.
  
  
  RESULTS
  RBD was successfully treated with immunotherapy in both patients. Score on the RBD screening questionnaire dropped from 10 to 1 or 0, allied with the normalization of polysomnographic findings.
  
  
  CONCLUSIONS
  A marked improvement in RBD after immunotherapy in PCD raises the hypothesis that secondary RBD may be an immune-mediated sleep disorder.
authors.affiliation: Movement Disorders Unit, Neurology Service, University Hospital. Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Thiago Cardoso
authors.initials: TC
authors.lastname: Vale
authors.affiliation: Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal São Paulo, São Paulo, Brazil.
authors.forename: Lucila Bizari
authors.initials: LB
authors.lastname: Fernandes do Prado
authors.affiliation: Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal São Paulo, São Paulo, Brazil.
authors.forename: Gilmar Fernandes
authors.initials: GF
authors.lastname: do Prado
authors.affiliation: Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal São Paulo, São Paulo, Brazil.
authors.forename: Orlando Graziani
authors.initials: OG
authors.lastname: Povoas Barsottini
authors.affiliation: Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal São Paulo, São Paulo, Brazil.
authors.forename: José Luiz
authors.initials: JL
authors.lastname: Pedroso
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D007167:Immunotherapy; D020362:Paraneoplastic Cerebellar Degeneration / Q000150:complications* / Q000276:immunology / Q000628:therapy*; D017286:Polysomnography; D020187:REM Sleep Behavior Disorder / Q000150:complications* / Q000276:immunology / Q000628:therapy*; D012890:Sleep
keywords: REM sleep; REM-sleep behavior disorder; immunotherapy; paraneoplastic cerebellar degeneration