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March 1995

Violent Sleep-Related Behavior Leading to Subdural Hemorrhage

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.

Arch Neurol. 1995;52(3):318-321. doi:10.1001/archneur.1995.00540270114028

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.

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