![]() ![]() RBD with concomitant narcolepsy may be considered a distinct phenotype of RBD. Other acute transient forms of RBD involve toxic metabolic encephalopathy-most commonly involving ethanol use. The most likely antidepressants that will incite an RBD episode are serotonin reuptake inhibitors (fluoxetine), tricyclic antidepressants (mirtazapine, protriptyline, amitriptyline, nortriptyline, desipramine, imipramine), and monoamine oxidase inhibitors (phenelzine and selegiline). ĭrug-induced RBD is common in individuals who are taking antidepressants. Studies have also suggested associations with traumatic brain injury (TBI), post-traumatic stress syndrome (PTSD), congenital and neurodevelopmental disorders. The literature suggests that RBD is precipitated by aberrant connections between the brainstem control of muscle tonicity and the cortex. Idiopathic RBD is most suggestive in neurodegenerative synucleinopathies, including dementia with Lewy bodies, Parkinson's disease, olivopontocerebellar degeneration, multiple-system atrophy, and Shy-Drager syndrome. RBD can be divided into three categories: Predisposing factors that increase RBD diathesis include elderly age, male sex, narcolepsy, antidepressant use, and neurological disorders. Counseling and management of RBD focus on injury prevention and the treatment of underlying precipitating disorders in addition to pharmacological treatment of severe cases using oral medications such as melatonin or Clonazepam. This topic will review the etiology, epidemiology, pathogenesis, clinical features, evaluation, management, and prognosis of RBD in adults. The diagnosis requires confirmation by an in-laboratory sleep study (polysomnography) with video recording, which helps assert abnormal behaviors during REM sleep and excludes other sleep disorders. Symptoms of RBD may precede neurodegenerative disorders by decades therefore, a careful history is significant in assessing these patients. The strongest correlation exists between RBD and comorbid neurodegenerative alpha-synucleinopathies (i.e., Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy). RBD has been associated with antidepressant use as well as narcolepsy. These symptoms may bring serious harm to the individual themselves and their sleeping partners. Rapid eye movement behavior disorder (RBD) is a parasomnia involving dream enactment behavior associated with loss of atonia during rapid eye movement (REM) sleep. Describe the importance of interprofessional team strategies for improving care coordination and communication to advance management of rapid eye movement behavior disorder and improve outcomes.Review the treatment and management options available for rapid eye movement behavior disorder.Outline the appropriate evaluation of rapid eye movement behavior disorder. ![]() Identify the etiology of rapid eye movement behavior disorder.This activity describes the evaluation and management of RBD and highlights the role of the healthcare team in improving care for patients with this condition. Intermittent reevaluations are available when appropriate, and we are always available to answer any questions referring providers have during this process.Rapid eye movement behavior disorder (RBD) is parasomnia strongly linked to neurodegenerative diseases, and it can also be very disturbing and lead to injury requiring medical attention. In turn, our sleep specialists will only recommend prescription of medications which have been used by the patient in a safe, appropriate, and stable manner. To minimize miscommunication between patients and providers, and to ensure our patients will have continuity of care, our sleep specialists will not write opioid prescriptions for new patients residing outside of Tennessee who do not have a local provider willing to assume this responsibility. Therefore, we require that new patients residing outside of Tennessee have a treating physician willing to assume prescriptive responsibilities for opioid prescriptions. For new patients who reside outside of Tennessee, specific medications such as opioids may not be able to be prescribed. These guidelines include minimizing use of controlled substances and treating patients with the lowest possible doses. Our sleep clinic follows national and Tennessee Guidelines for the prescribing of controlled substances. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |