Rapid eye movement sleep behaviour disorder in brain injury: A complex case requiring close coordination of care.

Abstract

Neurorehabilitation is interdisciplinary and cross-sectorial, requiring the coordinated effort of diverse sectors, professions, patients and communities to manage complex condition-related disabilities. A more holistic approach to experimental rehabilitation can incorporate individualized treatment plans into rehabilitation research to improve overall clinical care. This case aims to highlight the benefit of collaboration between neurology, psychiatry, physiatry and rehabilitation therapists to successfully rehabilitate complex patients. A 72-year-old gentleman with history of depression, anxiety and sleep difficulties presented to our institution one year after a stroke for help managing exacerbations of his premorbid conditions. The patient had a hemorrhagic stroke which required craniectomy and led to seizures. Past history was unclear regarding what workups had been done but was suggestive of rapid eye movement (REM) sleep behavior disorder (RBD). Given the numerous medications patient had tried in the past and since his stroke, a true multidisciplinary team was needed and his case required close coordination to successfully diagnose the reason for each of his symptoms and to provide treatments and rehabilitation. The correct diagnosis was only achieved by clear communication among team members which allowed for optimal treatment and improvement with therapies.