ABSTRACT
Rhythmic movement disorder, also known as jactatio capitis nocturna, is an infancy and childhood sleep-related disorder charactherized by repetitive movements occurring immediately prior to sleep onset and sustained into light sleep. We report a 19-year-old man with a history of headbanging and repetitive bodyrocking since infancy, occurring on a daily basis at sleep onset. He was born a premature baby but psychomotor milestones were unremarkable. Physical and neurological diagnostic workups were unremarkable. A hospital-based sleep study showed: total sleep time: 178 min; sleep efficiency index 35.8; sleep latency 65 min; REM latency 189 mim. There were no respiratory events and head movements occurred at 4/min during wakefulness, stages 1 and 2 NREM sleep. No tonic or phasic electromyographic abnormalities were recorded during REM sleep. A clinical diagnosis of rhythmic movement disorder was performed on the basis of the clinical and sleep studies data. Clonazepam (0.5 mg/day) and midazolam (15 mg/day) yielded no clinical improvement. Imipramine (10 mg/day) produced good clinical outcome. In summary, we report a RDM case with atypical clinical and therapeutical features.
Subject(s)
Humans , Male , Adult , Sleep Wake Disorders/diagnosis , Sleep, REM , Stereotypic Movement Disorder/diagnosis , Imipramine/therapeutic use , Periodicity , Polysomnography , Sleep Wake Disorders/drug therapy , Stereotypic Movement Disorder/drug therapyABSTRACT
E estudado um caso de abso e dependência a benzodiazepinicos com tolerância a alguns (psicomotor, sedativo), mas näo a todos (amnéstico) os efeitos dessas drogas (tolerância diferencial) e síndrome de abstinência com acentuaçäo de traços paranóides de personalidade