I Don’t Sleep Walk

Written by Tad. Posted in Kooks

My patient was a 34-year-old man who was brought in by ambulance after having a seizure. He was confused and not able to tell us what had happened. A while later, the wife arrived and said the patient woke up in the middle of the night, as he was prone to doing lately. She said he was pacing around the house when she heard a thud on the floor. She found him having a grand mal seizure.

For the last several months, the wife said, the patient had been behaving abnormally, especially at night. She said he would get up several times during the night during which time he would stretch, groan, rub his hands over his hair, pound his chest then jump back into bed. Sometimes, he would wander aimlessly around the house before finally going back to sleep.

The patient and his wife had argued over this because the patient denied any knowledge of these spells and it was his belief that she was not telling the truth when she would describe them.

When the patient recovered from the seizure and was back to his normal self, he admitted to several other worrisome symptoms. For example, he might be driving down the freeway when he would get the feeling he needed to jump out of the car. His hands would come off the steering wheel and fall to his lap. He felt an intense internal conflict as he really wanted to jump out of the car but was completely unable to move. This would quickly pass and he was able to continue to drive normally. He also admitted to having frequent feelings of déjà vu. *

This is a very interesting case of what most certainly was a new diagnosis of temporal lobe epilepsy. **

Here is a case report I found in the medical literature that describes night behavior like my patient had. I paraphrase it here:

The patient is a 39-year-old man with no family history for epilepsy or sleepwalking. From age 6, the patient had episodes while asleep during which he suddenly woke up, screamed, and had complex and movements of his arms and legs. Sometimes he fell out of bed. In other episodes, he got out of bed and walked around the room with violent movements, screaming with a terrified expression. Lastly, he went back to bed. His parents thought that he seemed to be conscious throughout the seizure and that he was aware of it, though the patient denied this. These episodes lasted about one minute. www.journalsleep.org/Articles/250609

* http://en.wikipedia.org/wiki/Déjà_vu

** http://en.wikipedia.org/wiki/Temporal_lobe_epilepsy

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