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A Case of Rapid Eye Movement Sleep Behavior Disorder in Parkinson Disease Treated With Sodium Oxybate

Jennifer Liebenthal, MD1; Jason Valerio, MSc, MD, FRCPC1,2; Chad Ruoff, MD1; Mark Mahowald, MD1
[+] Author Affiliations
1Stanford Sleep Medicine Center, Redwood City, California
2UBC Health Sciences Center Hospital, Vancouver, British Columbia, Canada
JAMA Neurol. 2016;73(1):126-127. doi:10.1001/jamaneurol.2015.2904.
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This case report describes a man in his late 60s with sleep behavior disorder and worsening dream enactment behavior.

Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by altered dream mentation, vocalizations, and dream enactment behavior (DEB). The motor behavior is often aggressive, resulting in potential injury to the patient or bed partner. Clonazepam and melatonin are considered standard treatments. Limited data exist on the use of alternative agents when standard medications fail. We report a case of successfully treated RBD in advanced Parkinson disease (PD) with sodium oxybate in a patient refractory to both standard and alternative pharmacologic agents.

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Rapid Eye Movement Behavior Disorder and Violent Events

Despite removing all objects from the bedroom and laying the mattress onto the floor, the patient continued to strike out at walls and the ground, causing self-injury and damage to property during dream enactment behavior.

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