**6. Ethical considerations**

As stated previously, development of RBD can herald a diagnosis of potentially disabling neurological disorders by over a decade. While not every patient with primary RBD will go on to develop one of these conditions, we believe that patients should be informed of the association between RBD and the alpha synucleinopathies and therefore their risk of developing one of these disorders. The discussion should be geared towards ensuring periodic follow up and reducing anxiety by answering any questions the patient may have on the subject. Serial neurologic exams, either comprehensive or focused on Parkinsonian features like tremor, rigidity, and bradykinesia should be performed. This can ensure early, effective treatment of motor and other non-motor symptoms that can positively impact patients' quality of life.
