REM behavior disorder in children

Rapid eye movement sleep behavior disorder, also called REM behavior disorder (RBD), is a condition characterized by loss of REM atonia, vivid dreaming, and dream-enacting motor activity or vocalizations. These dream enacting behaviors can at times lead to injury to self or others. Although the condition is more common among elderly males with neurodegenerative disease, RBD has also been described in the pediatric age group. A few reports of RBD in children have been published over the last three decades. The etiologies of RBD in younger people are unknown but may relate to neurodegenerative processes, disorders of amine signaling, or autoimmune disease. RBD in children most commonly occurs in children taking serotonin reuptake inhibitors (SSRIs) or in those with narcolepsy, Juvenile Parkinson’s disease, or autism. The diagnosis of RBD is established by polysomnography, in which loss of REM atonia and excessive motor activity can be documented. Important differential diagnoses include other parasomnias, epilepsy, or periodic leg movements of sleep. No treatment has been definitively established, but removal of aggravating drugs and treatment with clonazepam has been reported effective.