Wilson's disease presenting as rapid eye movement sleep behavior disorder: a possible window to early treatment



Document title: Wilson's disease presenting as rapid eye movement sleep behavior disorder: a possible window to early treatment
Journal: Arquivos de neuro-psiquiatria
Database: PERIÓDICA
System number: 000378576
ISSN: 0004-282X
Authors: 1
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Institutions: 1Universidade de Sao Paulo, Faculdade de Medicina, Sao Paulo. Brasil
Year:
Season: Sep
Volumen: 72
Number: 9
Pages: 653-656
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Caso clínico, analítico
English abstract Objective To describe characteristics of REM sleep behavior disorder in Wilson’s disease. Method Questionnaire-based interviews (patients and relatives), neurological examinations, two-week prospective dream-diary, video-polysomnography, transcranial sonography, MRI. Results Four Wilson’s disease cases with REM sleep behavior disorder were described; three had REM sleep behavior disorder as initial symptom. All showed mesencephalic tegmental/tectal sonographic hyperechogenicities and two presented ponto-mesencephalic tegmental MRI hyperintensities. Conclusion This first description of REM sleep behavior disorder in Wilson’s disease in literature documents REM sleep behavior disorder as a possible presenting symptom of Wilson’s disease and adds further evidence to the parallelism of Parkinson’s disease and Wilson’s disease in phenotype and brainstem topography, which ought to be further studied. REM sleep behavior disorder has prognostic relevance for neurodegeneration in α-synucleinopathies. In Wilson’s disease, usefulness of early diagnosis and treatment are already well established. REM sleep behavior disorder in Wilson’s disease offers a possible theoretical model for potential early treatment in this extrapyramidal and brainstem paradigm syndrome, previewing the possibility of neuroprotective treatment for REM sleep behavior disorder in “pre-clinical” Parkinson’s disease
Portuguese abstract Objetivo Descrever características do transtorno comportamental do sono REM (TCSR) na doença de Wilson (DW). Método Aplicação de entrevistas, vídeo-polissonografia, sonografia transcraniana (STC), ressonância magnética (RM), diário de sonhos. Resultados Descrevemos quatro casos de DW com TCSR. Três apresentaram o TCSR como primeira manifestação. Todos mostraram hiperecogenicidades mesencefálicas na STC, dois apresentaram hiperintensidades ponto-mesencefálicas na RM. Conclusão Esta é a primeira descrição do TCSR na DW. Relatamos o TCSR como um sintoma inicial da DW. Acrescentamos prova para o paralelismo entre a doença de Parkinson e DW, com relação aos fenótipos e localização das lesões cerebrais. Nas alfa-sinucleinopatias, o TCSR tem relevância prognóstica quanto à neurodegeneração. Na DW, já conhecemos a importância de diagnóstico e tratamento precoces. O TCSR na DW oferece um modelo para antecipar o tratamento desta síndrome de acometimento dos núcleos basais e tronco, vislumbrando a possibilidade de tratamento neuroprotetor para a fase “pré-clínica” da DP
Disciplines: Medicina
Keyword: Neurología,
Terapéutica y rehabilitación,
Diagnóstico temprano,
Sueño MOR,
Parkinsonismo,
Enfermedad de Wilson,
Parasomnia,
Trastornos del ánimo,
Neurodegeneración
Keyword: Medicine,
Neurology,
Therapeutics and rehabilitation,
Early diagnosis,
REM sleep,
Parkinsonism,
Wilson disease,
Parasomnia,
Sleep disorders,
Neurodegeneration
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