Sleep Related Movement Disorders

Question 1

Is liver disease a typical cause for RLS?

Answer 1

No. Renal disease, thyroid disease and peripheral neuropathy are.

Question 2

What % of patients will develop RLS symptoms on mirtazepine?

Answer 2

25%

Question 3

What PLMW (Periodic Limb Movements of Wakefulness) suggests RLS?

Answer 3

40 PLMW/hr

Question 4

1. What % of patients with PLMS have clinical symptoms of RLS?
2. What % of patients with RLS have PLMS (with or without arousals)?

Answer 4

1. 20%
2. 80%

Question 5

Diagnostic criteria for Adult and Pediatric PLMD

Answer 5

• 15/hr or more Adult. 5/hr or more pediatric
• Causes clinically significant sleep disturbance

or

• Causes daytime impairment
• There is no criteria for number of arousals

Question 6

What percent of infants will display some type of rhythmic sleep movement by age 9 months?

Answer 6

60%

Question 7

PSG criteria for bruxism

Answer 7

1. Sustained elevation of chin EMG (double the normal background) 0.25 to 2 seconds in duration with at least 3 events in a sequence (phasic) or at least 2 seconds in duration (tonic)
2. At least 3 seconds of stable background chin EMG before another bruxism can be scored
3. At least 2 audible teeth grinding episodes per night

Question 8

What medications can induce or make bruxism worse?

Answer 8

SSRIs

Question 9

How is Alternating leg muscle activation (ALMA) scored?

Answer 9

• Minimum of 4 discrete and alternating EMG bursts of leg muscle activity
• Minimum frequency of the alternating EMG bursts is 0.5 Hz
• Maximum frequency of the alternating EMG bursts is 3.0 Hz