Atypical headbanging presentation of idiopathic sleep related rhythmic movement disorder: Three cases with video-polysomnographic documentation

Shih Bin Yeh, Carlos H. Schenck

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Study Objectives: To describe three cases of sleep related, idiopathic rhythmic movement disorder (RMD) with atypical headbanging, consisting of head punching and head slapping. Methods: Three consecutive patients (2 males [11 and 13 years old) and one female [22 years old]) presented with atypical headbanging of 6 years, 7 years, and 17 years duration. In 2 cases, typical rhythmic headbanging (with use of the head) shifted after 3-4 years to atypical headbanging, with frontal head punching that was quasi-rhythmic. In one case, atypical headbanging (head-slapping) was the initial and only RMD. There was no injury from the headbanging. Prenatal, perinatal, developmental, behavioral-psychological, medical-neurological, and family histories were negative. Clinical evaluations and nocturnal video-polysomnography with seizure montage were performed on all patients. Results: Atypical headbanging was documented in all 3 cases; episodes always emerged late in the sleep cycle: from N2 sleep in 11 episodes, from REM sleep in 4 episodes, and from N1 sleep in 1 episode. Epileptiform activity was not detected. Clonazepam therapy was substantially effective in 1 case but not effective in 2 cases. Conclusions: These 3 cases of idiopathic atypical headbanging expand the literature on this RMD variant, as to our knowledge only one previously documented case has been reported.

Original languageEnglish (US)
Pages (from-to)403-411
Number of pages9
JournalJournal of Clinical Sleep Medicine
Volume8
Issue number4
DOIs
StatePublished - Aug 15 2012

Keywords

  • Central pattern generators
  • Clonazepam
  • Cyclic alternating pattern (CAP)
  • Handedness
  • Headbanging
  • Jactatio capitis nocturna
  • Parasomnia
  • Periodic limb movements/PLMs
  • RMD
  • Sleep related rhythmic movement disorder
  • Video-polysomnography

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