RESUMEN
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.
Asunto(s)
Humanos , Masculino , Adulto , Trastornos del Sueño-Vigilia/diagnóstico , Sueño REM , Trastorno de Movimiento Estereotipado/diagnóstico , Imipramina/uso terapéutico , Periodicidad , Polisomnografía , Trastornos del Sueño-Vigilia/tratamiento farmacológico , Trastorno de Movimiento Estereotipado/tratamiento farmacológicoRESUMEN
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