Periodic Limb Movements in a Comatose Patient: Case Report

Area of Science:

• Neurology
• Sleep Medicine
• Neurophysiology

Background:

• Periodic limb movements (PLMs) are typically associated with sleep disorders or primary conditions.
• PLMs have not been previously documented in comatose patients.

Observation:

• A 66-year-old male patient, without prior sleep disorders, developed PLMs during a coma.
• The coma was caused by a large right hemispheric abscess leading to a midline shift.
• Video and electromyographic recordings confirmed bilateral periodic bursts in the tibialis anterior muscles every 7-15 seconds, lacking EEG correlation.

Findings:

• This case presents the first documented instance of PLMs in a comatose state.
• The observed PLMs occurred despite the loss of consciousness and structural brain pathology.
• Post-recovery, PLMs persisted but were only evident during sleep.

Implications:

• PLMs can occur in the absence of consciousness, challenging previous understandings.
• This finding suggests that the neural networks supporting PLMs may be distinct from those supporting consciousness.
• Further research is warranted to explore the neurobiological underpinnings of PLMs in coma and structural brain lesions.