A 72-year-old previously healthy man is brought to the office by his wife because of strange movements and behavior during sleep that have been more frequent in the last three months. She states, "He's been waking me up in the middle of the night lately, wailing and flailing around as if he's having a nightmare. He sometimes turns angry in his sleep, kicking and punching me. I can easily wake him up, although he is frequently perplexed for a few seconds. Then he frequently recounts a dream in which he was protecting himself against an assault." The physical exam is ordinary. The most likely cause of this patient's disease is neurodegeneration caused by the buildup of which of the following?

Question

Quizplus · Accepted Answer

Eductional Objective: REM sleep behavior disorder (RBD) is a parasomnia characterized by dream-enactment actions as a result of REM sleep atonia loss. The majority of people with idiopathic RBD eventually acquire an alpha-synuclein neurodegenerative condition, most often Parkinson disease.

A 72-Year-Old Previously Healthy Man Is Brought to the Office