Neuroimaging of the brainstem in parasomnia overlap disorder

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

History A 40-year-old woman developed acute rhombencephalitis with cerebellar ataxia, a facial palsy, diplopia, right hearing loss, dysphagia, and dysarthria [1]. She reported vivid dreams associated with vigorous movements while asleep. On examination, she had right third, fifth, sixth, seventh, eighth, ninth, and tenth nerve palsies plus a right internuclear ophthalmoplegia, and a static cerebellar ataxia. Brain magnetic resonance imaging (MRI) suggested diffuse inflammatory lesions (Figure 44.1). The patient was treated with high-dose corticosteroids and improved within five weeks, except for the cerebellar ataxia and the anterior internuclear ophthalmoplegia. Six months after the episode, she developed an acute C2-7 and D5-6 myelitis; the brain and spinal MRI were unchanged. Two years later she developed abnormal sleep behaviors. Every night while asleep, and several times per night, she would speak, sing, have arm and leg jerks, and walk, open doors, walk into the kitchen or her son’s room, but did not hurt herself and had no recall of any associated mental content. While dreaming of giving him a spanking she slapped her son. She was mainly amnestic for the episodes the next morning. One year after the first neurological episode, she underwent video-polysomnography (Figure 44.2). Slow-wave sleep was interrupted by sudden arousals without any abnormal movement but she had nightly recurrent, quiet, sleep-associated walking episodes without dream recall suggestive of sleepwalking as an arousal disorder rather than as a rapid eye movement (REM) sleep behavior disorder (RBD). Clonazepam was not beneficial but a 9 mg melatonin dose partially improved the frequency and severity of RBD and sleepwalking.

Original languageEnglish (US)
Title of host publicationNeuroimaging of Sleep and Sleep Disorders
PublisherCambridge University Press
Pages349-351
Number of pages3
ISBN (Electronic)9781139088268
ISBN (Print)9781107018631
DOIs
StatePublished - Jan 1 2010

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Somnambulism
Parasomnias
Cerebellar Ataxia
REM Sleep Behavior Disorder
Neuroimaging
Brain Stem
Ocular Motility Disorders
Arousal
Nuclear Family
Sleep
Magnetic Resonance Imaging
Myelitis
Clonazepam
Dysarthria
Diplopia
Polysomnography
Facial Paralysis
Dyskinesias
Brain
Melatonin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Thorpy, M. J. (2010). Neuroimaging of the brainstem in parasomnia overlap disorder. In Neuroimaging of Sleep and Sleep Disorders (pp. 349-351). Cambridge University Press. https://doi.org/10.1017/CBO9781139088268

Neuroimaging of the brainstem in parasomnia overlap disorder. / Thorpy, Michael J.

Neuroimaging of Sleep and Sleep Disorders. Cambridge University Press, 2010. p. 349-351.

Research output: Chapter in Book/Report/Conference proceedingChapter

Thorpy, MJ 2010, Neuroimaging of the brainstem in parasomnia overlap disorder. in Neuroimaging of Sleep and Sleep Disorders. Cambridge University Press, pp. 349-351. https://doi.org/10.1017/CBO9781139088268
Thorpy MJ. Neuroimaging of the brainstem in parasomnia overlap disorder. In Neuroimaging of Sleep and Sleep Disorders. Cambridge University Press. 2010. p. 349-351 https://doi.org/10.1017/CBO9781139088268
Thorpy, Michael J. / Neuroimaging of the brainstem in parasomnia overlap disorder. Neuroimaging of Sleep and Sleep Disorders. Cambridge University Press, 2010. pp. 349-351
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