Tulburare a comportamentului somnului REM la o pacientă cu degenerescență cortico-bazală |[REM sleep behaviour disorder in a patient with cortico-basal involution]

Abstract

Introduction: New antidepressant agents are used in clinical practice. There is little data regarding the short- and long-term effects of REM sleep atonia, REM fasic activity, and REM sleep behaviour disorder. There is no clear definition of polysomnographic elements of “REM sleep without atonia”. This study aimed to present REM sleep behaviour disorder induced by an antidepressant. Material and method: 62-year-old patient with onset of disease 3 years before with asymmetric rest tremor followed by progressive bradikinesia, rigidity, without response to L-Dopa, with early dystonia of right foot. Rapidly progressive, she developed gait disorders, and after 2 years, it was diagnosed a depressive syndrome treated with Mirtazapin. At the very short time after Mirtazapin was initiated, the patient developed nightmares, screaming and violent behaviour during sleep. It was not confuzionale episodes and no hallucinations. Progressive withdrawal of Mirtazapin was followed by progressive disappearance of constitutive elements of REM parasomnia. Conclusion: Mirtazapin can induce early REM sleep behaviour disorders.