Department of Neurology, University of Wisconsin, Madison
Parasomnias are characterized by undesirable motor, verbal or experiential phenomenon/behaviors occurring in relation to sleep and sleep wake transition phases. They are believed to occur due to incomplete arousal from different sleep states, abnormal intrusions of wakefulness into different stages of sleep as well as de-afferentation of generators of locomotion from generators of sleep. They are classified as sleep wake transition parasomnias, NREM (non-rapid eye movement), REM (rapid eye movement) parasomnias and miscellaneous group.Accurate diagnosis of various parasomnias is important as they are associated with distinct group of predisposing factors.Associated conditions that require different treatment considerations which may be as innocuous as identification and removal of predisposing factors and reassurance. Correct diagnosis also invokes right differential diagnostic considerations and further investigations. Understanding of the underlying pathophysiology, semiological features and natural history of the particular parasomnia aids in counseling the patient and the parents, safety precautions to be undertaken and addressing psychosocial complications which are one of the most distressing factors for the patients. Correct diagnosis can be established fairly accurately based on careful and detailed clinical interview (including account from parents and bed partner), age of onset, time of occurrence, polysomnographic (PSG) studies and rarely an extended montage to study electrographic characteristics for differentiation with an ictal event.
Parasomnia, sleep start, confusional arousal, nightmares, sleep bruxism. rhythmic movement disorder, sleep walking, sleep paralysis, sleep enuresis, sleep talking, sleep terror, REM Sleep Behavior Disorder, nocturnal paroxysmal dystonia, nocturnal leg cramps, impaired sleep related penile erections, catathrenia, sleep related eating disorder
