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Violent sleep-related behavior leading to subdural hemorrhage
M E Dyken1, D C Lin-Dyken, P Seaba
1Department of Neurology, University of Iowa College of Medicine, Iowa City.
Objective:
To polysomnographically determine, using split-screen electroencephalographic-video analysis, the cause of violent sleep-related activity in a patient whose differential diagnosis includes sleep walking (somnambulism), pavor incubus (adult night terrors), nocturnal seizures, psychogenic wandering, and rapid eye movement sleep behavior disorder.
Setting:
The patient was referred to the University of Iowa, Department of Neurology Sleep Disorders Center, Iowa City, from the local community to evaluate a history of violent dreams associated with injury. The subject presented with a subdural hemorrhage that was discovered with magnetic resonance imaging.
Outcome:
The diagnosis of rapid eye movement sleep behavior disorder was confirmed after a characteristic spell of violent behavior, with an associated dream, was captured polysomnographically.