Posted by Strohl on April 09, 2003 at 15:27:22:In Reply to: exam posted by sleepdoc on April 08, 2003 at 20:55:36:
Chronic jerking presumably without daytime symptoms or "remembering'. The hisotry is not clear as to the observer or to the movements. Rhthmic movement disorder more often occurs in the younger ages but as this was "many years" it is likely. Tremors, tics (Tourette's), and myoclonus often have clues in wakefulness. Parkinson's trmor will presist into sleep (all stages) but also may remit. Seizures are in my mind unlikely but possible. Seizures are brough on by sleep. A PSG would document the history and if not seizrues the RX would be protection and reassurance. If there are interical spikes or a frank seizure then appropriate work-up by a neurologist might include imaging and/or sleep-deprived EEG. If the history is not shaking but kicking, then PLMs are possible and treatment selected to meet the symptom distress. At least that is my opinion today.