From parasomnia to agrypnia excitata - An illustrative case on diagnostic approach

Si-Lei Fong; Alfand Marl F Dy Closas; Thien Thien Lim; Phooi Leng Lean; Ee Chin Loh; Shen-Yang Lim; Ai Huey Tan

doi:10.1016/j.parkreldis.2023.105332

From parasomnia to agrypnia excitata - An illustrative case on diagnostic approach

Parkinsonism Relat Disord. 2023 Apr:109:105332. doi: 10.1016/j.parkreldis.2023.105332. Epub 2023 Mar 2.

Authors

Si-Lei Fong¹, Alfand Marl F Dy Closas¹, Thien Thien Lim², Phooi Leng Lean³, Ee Chin Loh⁴, Shen-Yang Lim¹, Ai Huey Tan⁵

Affiliations

¹ Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
² Island Hospital, Penang, Malaysia.
³ Department of Medicine, Seberang Jaya Hospital, Penang, Malaysia.
⁴ Division of Palliative Medicine, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
⁵ Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia. Electronic address: [email protected].

PMID: 36948111
DOI: 10.1016/j.parkreldis.2023.105332

Abstract

The diagnostic approach to sleep-related movements disorders is seldom discussed. We report a case of fatal familial insomnia who initially presented with persistent limb movements in sleep, which later progressed to a state of agrypnia excitata. Here, the evaluation of abnormal movements in sleep is discussed using a step-by-step diagnostic approach. Although no cure is available for fatal familial insomnia, prompt recognition of this condition is important to facilitate proper management, including the involvement of interdisciplinary neuropalliative care.

Keywords: Agrypnia excitata; Fatal familial insomnia; Prion disease; Sleep-related movement disorders.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Insomnia, Fatal Familial* / diagnosis
Insomnia, Fatal Familial* / genetics
Parasomnias* / diagnosis
Sleep