INCIDENTAL LEWY-BODY DISEASE IN A PATIENT WITH REM-SLEEP BEHAVIOR DISORDER

We studied an 84-year-old man with a 20-year history of nocturnal viol ent behavior during sleep, but no other clinically evident neuropsychi atric disorders. Polysomnographic investigations confirmed that he suf fered from REM sleep behavior disorder (RED). Histopathologic examinat ion revealed that he had Lewy body disease with a marked decrease of p igmented neurons in the locus ceruleus and substantia nigra. These his tologic findings represent the first documented evidence of a loss of brainstem monoaminergic neurons in clinically idiopathic RED and sugge st that Lewy body disease might provide an explanation for idiopathic RED in the aged.