47例REM睡眠行为障碍分析

The analysis of 47 REM sleep behavior disorder patients

目的 分析REM睡眠行为障碍的临床表现,探讨其病因、发病机制和治疗方法 .方法 回顾性分析47例REM睡眠行为障碍患者的病历资料.结果 47例患者均为中、老年人,均在熟睡过程中突然出现表现多样的行为障碍,多导睡眠图均为REM睡眠期出现肌弛缓现象消失而伴随肌电活动;病因为5例为帕金森病,3例为酒精戒断,1例为脑外伤,2例多系统萎缩,4例为药物滥用,32例为原发性;治疗应用氯硝西泮,或/和卡马西平、左旋多巴,所有患者有效.结论 REM睡眠行为障碍病因复杂、临床表现多样,经过合理药物、心理治疗,可以取得理想的治疗效果.

Objective To retrospectively study the clinical manifestations of REM sleep behavior disorder（RBD）, the possible causes, mechanisms, and therapy of the disease. Methods Forty--seven cases of RBD were analyzed retrospectively. Results All 47 patients were either senile or in middle ages. Various abnormal behaviors abruptly occurred in all patients during their sleep. The polysomnography in all cases showed a loss of normal muscular atonia and an appearance of EMG activities during REM sleep. The pathogeny of RBD among the patients was Parkinsonism 5 cases, alcohol withdraw 3 cases. cerebral trauma 1 cases.multiple system atrophy 2 cases.abuse substance 4 cases, and primary RBD 32 cases. All patients were responsive to the treatment with clonazepam and/or carbamazepine,levodopa. Conclusions The pathogeny of RBD was complex and the clinical manifestations were diversified; the cinical outcome was satisfactory with currently available drugs and psychotherapies.