Sleep-related movement disorders

In addition to restless legs syndrome and periodic limb movement syndrome, this group includes night cramps, bruxism, rhythmic movement disorders, etc.

Rhythmic movement disorders (sleep related rhythmic movement disorder) - a group of stereotypical repetitive movements of the head, trunk and limbs. They are more often observed in men. There are several forms of rhythmic movement disorders.

• Head banging is the most common form, most often seen in children under 1 year of age. It manifests itself as violent rhythmic banging of the forehead or cheek against a pillow, with the child raising himself up on outstretched arms. Rocking in the front-to-back direction in a position on elbows and knees with banging of the forehead against the wall or hitting the back of the head against the wall in a sitting position is also possible.
• When dizziness occurs, the child lies on his back with his eyes closed and makes pendulum-like head-swinging movements from side to side. The movements are smooth, uniform, their frequency is no more than 30 per minute, the duration of the episode is up to 10 minutes. Usually, up to 10 episodes of dizziness are observed, each of which consists of 10-100 movements separated by short intervals. In the morning, children remember the episode of "swinging" in their sleep quite well and easily reproduce it. In severe cases, the duration of "swinging" can reach 5 hours, and the number of movements - up to 2000, while vomiting and dizziness may occur. It is not always possible to stop the "swinging".
• Body rocking is the rocking of the body, but without head banging; sometimes it occurs as a “folding” phenomenon, which consists of rhythmically raising and lowering the upper half of the body from a supine position to a sitting position and back.
• There are also such forms of rhythmic movement disorders as body twitching, leg beating, and foot flailing.

Episodes of rhythmic movement disorders may be accompanied by sound phenomena (in the form of buzzing, humming and even monotonous singing), which in some cases can be quite loud. Stereotypically recurring motor disorders have varying degrees of intensity; in some children, they can reach the level of a “motor storm” that lasts for a long time and ends either with the child falling out of bed and waking up, or with a spontaneous end and subsequent deepening of sleep. At the age of up to 9 months, individual forms of rhythmic movement disorders are detected in 2/3 of children; by 18 months, their prevalence decreases by 2 times, and by 4 years, they are detected in only 8%. Rhythmic movement disorders can occur both in otherwise healthy children and in cases of mental retardation, autism and other forms of psychopathology, as well as with increased anxiety. In some cases, rhythmic movement disorders can lead to severe complications (skull fractures, subdural hematomas, cervical spine injuries, eye injuries, etc.). In the absence of concomitant gross psychoneurological symptoms (in particular, oligophrenia), the prognosis for rhythmic movement disorders is usually favorable. The polysomnographic picture is non-specific and only demonstrates the presence of a transition from sleep (any stage) to wakefulness, and also allows differentiating between the epileptic and non-epileptic origin of this phenomenon.

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