REM Sleep Behavior Disorder Differential Diagnoses

Updated: Mar 10, 2019
  • Author: Syed M S Ahmed, MD; Chief Editor: Selim R Benbadis, MD  more...
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Diagnostic Considerations

The following primary disorders of arousal should be considered in the differential diagnosis of rapid eye movement sleep behavior disorder (RBD):

  • Sleep terrors [9]

  • Sleep walking [9]

  • Confusional arousals

Secondary disorders of arousal that can be considered in the differential diagnosis of RBD include the following:

  • Obstructive sleep apnea (OSA) [13]

  • Periodic limb movements in sleep (PLMS)

  • Gastroesophageal reflux disease (GERD)

  • Nocturnal seizure - eg, frontal lobe epilepsy

Other differentials to consider include the following:

  • Posttraumatic stress disorder (PTSD)

  • Psychogenic dissociative disease

  • Malingering

  • Frightening hypnagogic or hypnopompic hallucinations

  • Effect of alcohol or drug administration or withdrawal

  • Epilepsy in adults with mental retardation

  • Epilepsy in children with mental retardation

  • Absence seizures

Differential Diagnoses