Lesional REM sleep behavior disorder localizes to the dorsomedial pons

REM sleep behavior disorder (RBD) is characterized by dream enactment behaviors (DEB) and REM sleep without atonia (RSWA). A key structure in REM sleep muscle tone regulation in the rodent model is the sublateral dorsal (SLD) tegmental nucleus in the dorsomedial pons.1 Lesions of an analogous structure, the subceruleus (SC) nucleus are thought to mediate RSWA in humans, enabling DEB.1,2 However, in vivo human studies of discrete dorsomedial pontine lesions causing RBD in isolation have been limited.2–4 We report such a case of lesional RBD due to vasculitis. The Mayo Clinic Institutional Review Board approved this study.