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Neurology 1999;53:1868
© 1999 American Academy of Neurology
Brief Communications

Juvenile Parkinson’s disease with REM sleep behavior disorder, sleepiness, and daytime REM onset

David B. Rye, MD, PhD, Lisa H. Johnston, MD, Ray L. Watts, MD and Donald L. Bliwise, PhD

From the Department of Neurology, Emory University School of Medicine, and the Sleep Disorders Center at Wesley Woods Hospital, Atlanta, GA.

Address correspondence and reprint requests to Dr. David B. Rye, Emory University Department of Neurology, Woodruff Memorial Research Building, P.O. Drawer V, Suite 6000, Atlanta, GA 30322.

We describe an unmedicated patient with juvenile PD with difficulties maintaining wakefulness and the atonia of REM sleep. Laboratory testing showed enhanced muscle activity in REM sleep consistent with a history of dream enactment behavior (i.e., REM sleep behavior disorder) and daytime sleepiness, and REM-sleep onsets on multiple sleep latency testing. The results emphasize the potential role of dopamine and basal ganglia circuits in the modulation of activated behavioral states (e.g., wakefulness and REM sleep).

Key words: Dopamine—Alertness—Nocturnal movement—REM—Sleep—Narcolepsy.




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