Findings from various centers suggest the following characteristics. First, parkinsonism may be quite prevalent in RBD; second, RBD may be the initial manifestation of a parkinsonian disorder in a substantial number of RBD cases initially considered to be idiopathic; third, a high percentage of parkinsonian patients without sleep complaints may have either subclinical or clinical RBD; fourth, Lewy body pathology may be quite prevalent in RBD; and fifth, similar findings have been reported in various extra-pyramidal disorders.
A review of the world literature on RBD identified 280 published cases, of which 149 (53%) were closely associated with a neurological disorder (Schenck and Mahowald, 1996a). A parkinsonian disorder was the most prevalent neurological condition, affecting 43% (n = 64) of neurologically disordered RBD patients (representing 23% of n = 280 total cases); narcolepsy was the next most prevalent condition, affecting 25% (n = 38) of neurologically disordered RBD patients (representing 14% of n = 280 total cases), followed by cardiovascular disorders, dementias, and miscellaneous disorders.
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