Abstract
We reported a 17-year-ole male presented with repetitive head punching as rhythmic movement during sleep. Rhythmic movement disorder (RMD) during sleep refers to a number of activities characterized by repetitive stereotyped movements such as rhythmic oscillations of the head, limbs, or body. The repetitive movement like punching on the head in our case is a rare form. The patient's symptom was dramatically aggravated by dopamine agonist and responded well to dopamine antagonist. It is the first case report of dopamine-antagonist responsive repetitive head punching as rhythmic movement during sleep.