Violent sleep-related behavior leading to subdural hemorrhage
M. E. Dyken, D. C. Lin-Dyken, P. Seaba and T. Yamada
Department 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.