Adult-Onset NREM Parasomnia with Hypnopompic Hallucinatory Pain: A Case Report

Mantoan, Laura; Eriksson, Sofia; Nisbet, Angus; Walker, Matthew C.

doi:10.5665/sleep.2392

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…An extensive review of the literature provides little insight into this phenomenon. One similar report comes from Mantoan et al [5], who reported adult-onset NREM parasomnia with hypnopompic hallucinatory pain. Similar to our case, the episodes arose within 1-2 h of sleep onset and were associated with looking terrified and initial lack of responsiveness.…”

Section: Discussionmentioning

confidence: 82%

A Case of Complex and Abnormal Behaviors at Night: The Role of the Epilepsy Monitoring Unit in Diagnosis

et al. 2020

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Complex nocturnal behaviors associated with sleep have many potential causes, including parasomnias and epilepsy. Although the type of event and description can frequently lead to a diagnosis, sometimes it is challenging clinically to determine the cause of the behaviors, requiring a more in-depth investigation. We report the case of a 29-year-old woman with a long history of complex abnormal behaviors and visual hallucinations at night. An extensive clinical evaluation failed to reveal a definitive cause of these episodes, prompting a 3-day epilepsy monitoring unit admission. During the stay, several events were captured on video electroencephalography, leading to a conclusive final diagnosis. This case highlights the challenging task of finding a definitive diagnosis in cases of complex nocturnal behaviors and the potential role of an admission to an epilepsy monitoring unit to help diagnose the cause of these behaviors.

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Section: Discussionmentioning

confidence: 82%

A Case of Complex and Abnormal Behaviors at Night: The Role of the Epilepsy Monitoring Unit in Diagnosis

et al. 2020

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“…The final analysis included 16 articles ( Figure 1 ). Seven articles were excluded during the full-article and data extraction stage: one because the reported dream mentation experience occurred following alcohol intoxication ( 31 ); one included a case of POD ( 32 ); one reported no recall of dream mentation ( 33 ); one was a study of NREM dream mentation but not in the context of NREM parasomnias ( 34 ); and the remaining did not describe clear dream mentation ( 35 - 37 ).…”

Section: Resultsmentioning

confidence: 99%

Non-REM parasomnias: a scoping review of dreams and dreamlike mentation

Longe

Omodan²,

Leschziner³

et al. 2022

Croat Med J

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Aim To establish patterns or themes of dreams and dreamlike mentation content reported in all forms of non-rapid eye movement (NREM) parasomnias and to identify gaps in the current understanding of this topic. Methods A scoping review of available evidence on dreams and dreamlike mentation in NREM parasomnias was conducted in accordance with the PRISMA-ScR guidelines. We searched peer-reviewed literature using Google Scholar, PubMed, Ovid (Embase), Ovid Medline®, Global Health, and APA Psych Info. The Mixed Method Appraisal Tool (MMAT) was used to appraise the quality of selected articles. Results The final analysis included 16 studies. All of the studies were from high-income countries. The studies reported on dreams and dreamlike mentation in NREM parasomnias, but there was scarcity of literature for sexsomnia, sleep-related eating disorder, and confusional arousal. All of the studies had the highest quality as shown by the MMAT (76%-100%). Emotions such as apprehension and misfortune were associated with sleepwalking and sleep terrors. Conclusion Sleep studies involving collection of dream content immediately following NREM parasomnia could significantly minimize reporting bias and improve dream data quality.

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“…In the literature, we have found only one case presenting with pain in association with a NREM parasomnia. 3 In the previous case report, no associated psychological, physical, or sexual trauma was disclosed. The patient recalled an accompanying sense of "fi ghting to stay alive" associated with intense panic and fast, regular palpitations.…”

Section: Discussionmentioning

confidence: 99%

“…3 We report a case of severe NREM parasomnia manifested by the previously unreported feature of lancinating throat pain.…”

Section: A S E R E P O R T Smentioning

confidence: 99%

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Adult NREM Parasomnia Associated with Lancinating Throat Pain

Bušková

Šonka

2014

Journal of Clinical Sleep Medicine

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We report the case of a 30-year-old woman presenting with dangerous nocturnal NREM episodes with the clinical feature of lancinating throat pain. We hypothesize that the pain may have represented sensory hallucination analogous to commonly recognized visual images associated with NREM parasomnias. This case is also unusual for probable psychological triggers that could play a role in the pathogenesis of the disease, as evidenced by successful psychotherapy. Keywords: NREM parasomnia, pain, psychotherapy Citation: Bušková J, Šonka K. Adult NREM parasomnia associated with lancinating throat pain. J Clin Sleep Med 2014;10(8):925-926. http://dx.doi.org/10.5664/jcsm.3974 C A S E R E P O R T SN REM parasomnias are arousal disorders emerging during slow wave sleep characterized by greatly variable behavioral and emotional expression.1 These episodes are usually followed by amnesia, but a minority of adult patients recall complex mental activity immediately before and during episodes.2 Thus far, only one case of such an episode associated with pain perception has been described. 3 We report a case of severe NREM parasomnia manifested by the previously unreported feature of lancinating throat pain. REPORT OF CASEThe patient is a 30-year-old, healthy young woman with a high school education, now on maternity leave with her fi rst child. She has suffered from "calm somnambulism" since childhood with no other medical history.Her husband arranged a consultation in our sleep clinic with regard to dangerous behavior exhibited by his wife while asleep. The episodes typically occurred within the fi rst two hours of sleep, and presented with sudden sat up straight in bed and somniloquy that suggestively corresponded to dreamlike visual images. At the beginning of the episode that prompted consultation, the subject began to dream that she was swallowing various indigestible objects (such as scissors, socks, dogs, needles, worms, pet hair), accompanied by terribly unpleasant subjective feelings and lancinating throat pain. She experienced this sensation so dramatically that she spent some time sitting up in bed vigorously trying to remove the object from her throat with her hands until she choked and gagged, injuring her throat, with pain persisting for a week. She was confused for several minutes after the episode and repeatedly asked her husband to remove the object from her throat. There was no identifi ed biopsychosocial trigger for these episodes from the preceding day.The last of these sporadic episodes involved a potential threat to their daughter. Their two-year-old daughter was sleeping with her parents as she had infl uenza. The episode started around midnight. The subject suddenly sat upright in bed, grabbed her daughter and forcibly opened her mouth, trying to insert her fi ngers into her mouth. Her husband acted quickly to protect their daughter. When he succeeded in waking his wife, she said that she had dreamt that her daughter swallowed a coin. She was not sure whether or not it was a dream for an entire day fol...

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Adult-Onset NREM Parasomnia with Hypnopompic Hallucinatory Pain: A Case Report

Cited by 5 publications

References 9 publications

A Case of Complex and Abnormal Behaviors at Night: The Role of the Epilepsy Monitoring Unit in Diagnosis

A Case of Complex and Abnormal Behaviors at Night: The Role of the Epilepsy Monitoring Unit in Diagnosis

Non-REM parasomnias: a scoping review of dreams and dreamlike mentation

Adult NREM Parasomnia Associated with Lancinating Throat Pain

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