Rhythmic movement disorder (head banging) in an adult during rapid eye movement sleep

Abstract

Sleep-related rhythmic movements (head banging or body rocking) are extremely common in normal infants and young children, but less than 5% of children over the age of 5 years old exhibit these stereotyped motor behaviors. They characteristically occur during drowsiness or sleep onset rather than in deep sleep or rapid eye movement (REM) sleep. We present a 27-year-old man with typical rhythmic movement disorder that had persisted into adult life and was restricted to REM sleep. This man is the oldest subject with this presentation reported to date and highlights the importance of recognizing this nocturnal movement disorder when it does occur in adults.

Sleep related rhythmic movement disorder revisited

“…In contrast to ICSD‐2 SRMD seems to persist quite frequently into adulthood, thus confirming the rare findings of other authors (Anderson et al. , 2006; Chisholm and Morehouse, 1996; Demirozu and Cohn, 1992; Happe et al.…”

“…Most reports on SRMD are on handicapped persons with SRMD occurring during daytime. Few cases in adult persons of normal intelligence have been reported in the literature (Anderson et al. , 2006; Chisholm and Morehouse, 1996; Demirozu and Cohn, 1992; Happe et al.…”

A Case with Dopamine-Antagonist Responsive Repetitive Head Punching as Rhythmic Movement Disorder during Sleep

“…The new onset of RMD during adulthood may be also possible. RMD specifically associated with REM sleep can occur in children6–8 and persist into adulthood 9. RMD is usually not associated with underlying psychiatric disorders except minor relationship with autism, attention deficit disorder, or anxiety disorder 8,10…”

Abstracts

“…Neurological findings are otherwise normal. The individual frequency of SMRD ranges from less than once per week to nightly, and clusters can occur during the same night 40–42, 47–49. Basically, the quality of sleep of children with SRMD is good, as daytime functioning is apparently unaffected,50 although a possible association with fatigue, daytime sleepiness, concentration difficulties, morning headache, and various psychosocial difficulties has been reported 41, 45, 48…”

“…Polysomnography helps to precisely characterize the SMRD episodes: (1) slow movements, with a frequency ranging from 0.5 to 2 Hz (rarely up to 3.5 Hz)45, (2) self‐limiting episodes lasting between seconds and 30 minutes, with a duration range depending on the individual patient and (3) no associated manifestations or neurological abnormalities 43. SRMDs can occur during presleep wakefulness, sleep‐awake transition, and during different phases of sleep (mostly non‐REM sleep) 40–43, 45, 47, 49, 61. They are associated with particular periodic EEG activity of non‐REM sleep, known as cycling alternating pattern activity.…”