Three Cases of Rapid Eye Movement Sleep Behavior Disorder after Encephalitis

Abstract

Received December 13, 2013 Revised May 5, 2014 Accepted May 15, 2014 Address for correspondence Sang Ahm Lee, MD, PhD Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea Tel: +82-2-3010-3445 Fax: +82-2-474-4691 E-mail: salee@amc.seoul.kr Most secondary form of rapid eye movement (REM) sleep behavior disorder (RBD) is associated with neurodegenerative diseases or narcolepsy. However, RBD may also occur in acute or subacute conditions involving the central nervous system, for example structural lesions, encephalitis, Guillain-Barre syndrome, drug and alcohol withdrawal. Three patients developed RBD after acute inflammatory encephalitis, which lasted for 3 months to 1 year. They talked, moved and walked nightly while asleep. During night polysomnography, there were REM sleep without atonia and abnormally increased REM sleep as 37–87% of total sleep. The RBD improved with clonazepam and there was no recurrence at 1 year follow-up. The global encephalitis could be responsible for the RBD and destruction of sleep architecture. J Korean Sleep Res Soc 2014;11(1):38-43