Posted by Strohl on April 06, 2003 at 06:38:02:In Reply to: parasomnias posted by David Bresch on March 26, 2003 at 20:01:47:
All good questions. Here are my thoughts
1) I believe that the extra leads are suggested to demonstrate increased EMG in REM that comes and goes as well as to document if a full RBD event occurs (movements, shouting, banging, out of REM).
2)Those cases in which sleep paralysis has been recorded occur out of REM sleep. As for the "dissociated REM" I beleive it means that the muscle paralysis part of REM is dissociated from the Waking EEG. I have not seen a record but I would expect there to be Alpha and mixed frequency like wakefulness.
3)Good question. The PSG would be indicated if there is good historical data for movement disorders such as tremors, rhythmic movement disorder, or fragmentary myclonus, or if treatment for RLS does not seem to be working.
40 Paroxysmal nocturnal dystonia occurs after an arousal from NREM and is often quite dramatic and involves major posturing (dyskinetic features), in comparison to cramps which are localized to the calves or confusional arousals which may not have any pain or sterotypical movements associated with the arousal.