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Mark E. Dyken, MD; Deborah C. Lin-Dyken, MD; Peter Seaba, MSEE; Thoru Yamada, MD

Arch Neurol. 1995;52(3):318-321.

Abstract
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.

Author Affiliations
From the Departments of Neurology Sleep Disorders Center (Drs Dyken and Yamada and Mr Seaba) and the Department of Pediatrics, Division of Developmental Disabilities (Dr Lin-Dyken), University of Iowa College of Medicine, Iowa City.

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