DIAGNOSING RHYTHMIC MOVEMENT DISORDER WITH VIDEO-POLYSOMNOGRAPHY

We evaluated the utility of accurate clinical and electrophysiologic c haracterization in the diagnosis of the rhythmic movement disorder, Se ven children with an age range of 1-12 years, referred for evaluation of relatively violent nocturnal behaviors, were clinically assessed du ring split-screen, video-polysomnographic monitoring sessions, as they experienced unusual nocturnal movements. Differential diagnoses inclu ded self-injurious waking behaviors, seizures, and parasomnias such as somnambulism (sleepwalking), pavor nocturnus (night terrors), and the rhythmic movement disorder (headbanging, bodyrocking, and legbanging) . The character of movements, level of responsiveness, and electrophys iologic stage of sleep was determined during typical spells, In all th e subjects experienced 37 periods of headbanging, bodyrocking, and leg banging that were strongly associated with stage 2 non-rapid eye movem ent sleep and K-complexes, The patients were unresponsive during and a mnestic for the events, Because the differential for the rhythmic move ment disorder includes a large number of disorders associated With abn ormal and at times violent nocturnal movements, diagnosis can be great ly enhanced by documenting suspected nocturnal behaviors with thorough clinical assessment during split-screen, video-polysomnographic analy sis. (C) 1997 by Elsevier Science Inc.