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NEUROLOGY 1989;39:1519
© 1989 American Academy of Neurology

Magnetic resonance findings in REM sleep behavior disorder

Antonio Culebras, MD and James T. Moore, RPSGT

From the Sleep Center, Neurology Service of the Veterans Administration Medical Center and State University of New York, and Sleep Center, Community General Hospital, Syracuse, NY.

Rapid eye movement (REM) sleep behavior disorder is characterized by bizarre acts during nocturnal sleep that may lead to physical injuries. Dream content suggests that motor overactivity is an attempted dream enactment and polygraphic studies reveal REM stage without atonia, an alteration of REM sleep generation that facilitates excessive motor activity. In 6 patients with REM sleep behavior disorder, MRI of the brain showed multifocal signal intensity lesions suggestive of lacunar infarcts in periventricular regions (5 patients) and in dorsal pontomesencephalic areas (3 patients). REM sleep behavior disorder may be the result of injury to the midrostral tegmentum nuclei, the tegmentoreticular tracts, or both. This condition is easily controlled with clonazepam.

Address correspondence and reprint requests to Dr. Culebras, Neurology Service (127), VAMC 800 Irving Avenue, Syracuse, NY 13210.

Presented in part at the forty-first annual meeting of the American Academy of Neurology, Chicago, IL, April 1989.

Received January 23, 1989. Accepted for publication in final form May 22, 1989.

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