Rhythmic Movement Disorder

Authors: I. Příhodová
Authors‘ workplace: Neurologická klinika 1. LF UK a VFN
Published in: Cesk Slov Neurol N 2012; 75/108(4): 415-419
Category: Review Article


Sleep-related rhythmic movements (RM) (jactatio capitis et corporis nocturna) are mostly transient physiological phenomena in infants and toddlers. They are characterized by stereotyped, repetitive rhythmic movements of head, neck and trunk, less commonly of extremities (head banging, body rocking, head and body rolling, leg banging or rolling). In some cases they can persist into childhood or adulthood and may be associated with sleep fragmentation, impaired daytime functioning or with a risk of injury. RM with clinical consequences are known as rhythmic movement disorder (RMD). RM occur during sleep onset or during superficial sleep but they can be present during any sleep stage. RM can be very intense and disturb sleep of the entire family. Aetiology and pathogenesis are unknown. RM in infants and toddlers do not require any treatment. Various psychotherapeutic techniques and short-term administration of benzodizepines are used to manage RMD. Obstructive sleep apnea or restless legs syndrome can play a role as a trigger of RM and nocturnal videopolysomnography may be helpful for accurate diagnosis of RMD and associated sleep disorders.

Key words:
rhythmic movements in sleep – jactatio capitis and corporis nocturna – rhythmic movement disorder


1. American Academy of Sleep Medicine. The International Classification of Sleep Disorders. Diagnostic and Coding manual. 2nd ed. Westchester, IL: American Academy of Sleep Medicine 2005: 193–196.

2. Thorpy MJ, Glovinsky PB. Headbanging (jactatio capitis nocturna). In: Kryger MH, Roth T, Dement WC (eds). Principles and practice of sleep medicine. Philadelphia: WB Saunders 1989: 648–654.

3. Klackenberg G. Rhythmic movements in infancy and early childhood. Acta Paediatr Scand Suppl 1971; 224: 74–83.

4. Hoban TF. Rhythmic movement disorder in children. CNS Spectrums 2003; 8(2): 135–138.

5. Mayer G, Wilde-Frenz J, Kurella B. Sleep related rhythmic movement disorder revisited. J Sleep Res 2007; 16(1): 110–116.

6. Šonka K, Nevšímalová S. Abnormní pohyby související se spánkem. In: Nevšímalová S, Šonka K 

(eds). Poruchy spánku a bdění. Praha: Galén 2007:


7. Manni R, Terzaghi M. Rhythmic movements during sleep: a physiological and pathological profile. Neurol Sci 2005; 26 (Suppl 3): s181–s185.

8. Walsh JK, Kramer M, Skinner JE. A case report of jactatio capitis nocturna. Am J Psychiatry 1981; 138(4): 524–526.

9. Reimao R, Lemmi H. Jactatio capitis nocturnus: report of a case in an adult. Arq Neuropsyquiatr 1985; 43(1): 86–90.

10. Bastuji H. Rhythms of falling asleep persisting in adults. Two cases without mental deficiency. Neurophysiol Clin 1994; 24(2): 160–166.

11. Chisholm T, Morehouse RL. Adult headbanging: sleep studies and treatment. Sleep 1996; 19(4):


12. Dyken ME, Lin-Dyken DC, Yamada T. Diagnosing rhythmic movement disorder with video-polysomnography. Pediatr Neurol 1997; 16(1): 37–41.

13. Alves RS, Aloe F, Silva AB, Tavares SM. Jactatio capitis nocturna with persistence in adulthood. Case report. Arq Neuropsiquiatr 1998; 56(3B): 655–657.

14. Kaneda R, Furuta H, Kazuto K, Arayama K, Sano J,

Koshino Y. An unusual case of rhythmic movement disorder. Psychiatry Clin Neurosci 2000; 54(3):


15. Happe S, Ludemann P, Ringelstein EB. Persistence of rhythmic movement disorder beyond childhood: a videotape demonstration. Mov Disord 2000; 15(6): 1296–1298.

16. Hashizume Y, Yoshijima H, Uchimura A, Maeda H.

Case of head banging that continued to adolescence. Psychiatry Clin Neurosci 2002; 56(3):


17. Kohyama J, Matsukura F, Kimura K, Tachibana N.

Rhythmic movement disorder: polysomnographic study and summary of reported cases. Brain Dev 2002; 24(1): 33–38.

18. Štěpánová I, Nevšímalová S, Hanušová J. Rhythmic movement disorder in sleep persisting into childhood and adulthood. Sleep 2005; 28(7): 851–857.

19. Gagnon P, De Koninck J. Repetitive head movements during REM sleep. Biol Psychiatry 1985; 20(2): 176–178.

20. Kempenaers C, Bouillon E, Mendlewicz J. A rhythmic movement disorder in REM sleep: A case report. Sleep 1994; 17(3): 274–249.

21. Anderson KN, Smith IE, Shneerson JM. Rhythmic movement disorder (head banging) in an adult during rapid eye movement sleep. Mov Dis 2006; 21(6): 866–867.

22. Mattewald A, Casturi L, Subramanian S. A child with REM sleep disturbance. J Clin Sleep Med 2010; 6(1): 97–100.

22. Manni R, Terzaghi M. Rhythmic movements in idio­pathic REM sleep behavior disorder. Mov Dis 2007; 22(12): 1797–1800.

24. Xu Z, Anderson KN, Shneerson JM. Association of idiopathic rapid eye movement sleep behavior disorder in an adult with persistent, childhood onset rhythmic movement disorder. J Clin Sleep Med 2009; 15(4): 374–375.

25. Merlino G, Serafini A, Dolso P, Canesin R, Valente M,

Gigli CL. Association of body rolling, leg rolling and rhythmic feet movements in a young adult: a video-polysomnographic study performed before and after one night of clonazepam. Mov Dis 2008; 23(4):


26. Su Ch, Miao J, Liu Y, Liu R, Lei G, Zhang W

et al. Multiple forms of rhythmic movements in adolescent boy with rhythmic movement disorder. Clin Neurol Neurosurg 2009; 111(10):


27. Janković SM, Sokić DV, Vojvodić NM, Ristić AJ, Kostić VS. Multiple rhythmic movement disorders in a teenager boy with excellent response to clonazepam. Mov Dis 2008; 18(3): 215–219.

28. Mindell JA, Owens JA. Head banging and body rocking. In: Mindell JA, Owens JA. A clinical guide to pediatric sleep. Philadelphia: Lippincott Williams Wilkins 2003: 97–105.

29. Sallustro F, Atwell CW. Body rocking, head banging, and head rolling in normal children. J Pediatr 1978; 93(4): 704–708.

30. Bonakis A, Kritikou I, Vagiakis E, Nanas S, Papageorgiou SG. A familial case of sleep rhythmic movement disorder persistent into adulthood; approach to pathophysiology. Mov Dis 2011; 26(9):


31. Vogel W, Stein DJ. Citalopram for head banging. J Am Acad Child Adolesc Psychiatry 2000; 39(5):


32. Silvestri R, Gagliano A, Aricò I, Calarese T, Cedro C,

Bruni O et al. Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography. Sleep Med 2009; 10(10): 1132–1138.

33. Kravitz H, Rosenthal V, Teplitz Z, Murphy I, Lesser R.

A study of headbanging in infants and children. Dis Nerv Syst 1960; 21: 203–208.

34. Kavey NB, Jewitch DE, Bloomingdale E, Gidro-Frank S. Jactatio capitis nocturna: a longitudinal study of a boy with familial history. Sleep Res 1981; 10: 208.

35. Laberge L,Tremblay RE, Vitaro F, Montplaisir J. Development of parasomnias from childhood to early adolescence. Pediatrics 2000; 106(1): 67–74.

36. Etzioni T, Katz N, Hering E, Ravid S, Pillar G. Controlled sleep restriction for rhythmic movement disorder. J Pediatr 2005; 147(3): 393–395.

37. Tassinari CA, Rubolli G, Gardella E, Cantalupo G, Calandra-Buonaura G, Vendovello M et al. Central pattern generator for a common semiology in fronto limbic seizures and parasomnias. A neuroethologic approach. Neurol Sci 2005; 26(S): 225–232.

38. Manni R, Terzaghi M, Sartori I, Veggiotti P, Parrino L. Rhythmic movement disorder and cyclic alternating pattern during sleep: A video-polysomnoghraphic study in a 9-year old boy. Mov Dis 2004; 19(10): 1186–1190.

39. Chirakalwasan N, Hassan F, Kaplish N, Fetterolf J, Chervin RD. Near resolution of sleep related rhythmic movement disorder after CPAP for OSA. Sleep Med 2009; 10(4): 497–500.

40. Lombardi C, Provini F, Vetrugno R, Plazi G, Lugaresi E, Mantagna P. Pelvic movements as a rhythmic motor manifestation associated with restless legs syndrome. Mov Dis 2003; 18(1): 110–113.

41. Walters AS, Hening WA, Chockroverty S. Frequent occurrence of myoclonus while awake and at rest, body rocking and marching in place in a subpopulation of patients with restless legs syndrome. Acta Neurol Acand 1988; 77(5): 418–421.

42. Gharagozlou P, Seyffert M, Santos M, Chokroverty S. Rhythmic movement disorder associated with respiratory arousals and improved by CPAP titration in a patient with restless legs syndrome and sleep apnea. Sleep Med 2009; 10(4): 501–503.

43. Khan A, Auger RR, Kushida CA. Ramar K. Rhythmic movement disorder. Sleep Medicine 2008; 9(3): 329–330.

44. Manni R, Tartara A. Clonazepam treatment of RMD. Sleep 1997; 20(9): 812.

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