A 62-year-old Man with Facial and Finger Twitching

Journal of Clinical Sleep Medicine, Vol. 12, No. 2, 2016 A 64-year-old stationery engraver presented with several months of twitching of his fingers and face occurring predominantly during sleep. The twitches would occur asymmetrically and were not associated with any gross motor activity. He could identify no precipitating factors preceding the development of his muscle twitches. His wife reported a history of snoring; however, the patient denied morning headaches or dry mouth. There were no symptoms of daytime sleepiness (Epworth Sleepiness Scale score was 4), restless legs syndrome, sleeprelated limb movements, or dream enactment. Polysomnography (PSG) demonstrated frequent short bursts of muscle activity throughout wakefulness, NREM, and REM sleep in both upper and lower extremity EMG leads, which were unassociated with arousals or breathing events SLEEP MEDICINE PEARLS