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Pediatric Neurology 2013-Sep

Brain tumor presenting as somnambulism in an adolescent.

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Priya S Prashad
Carole L Marcus
Lawrence W Brown
Dennis J Dlugos
Tamara Feygin
Brian N Harding
Gregory G Heuer
Thornton B Alexander Mason

Keywords

Abstract

BACKGROUND

Sleepwalking is typically a benign and self-limited non-rapid eye movement parasomnia of childhood.

METHODS

We describe an unusual 15-year-old boy referred to our sleep center for new-onset sleepwalking.

RESULTS

An overnight polysomnogram was normal from a respiratory standpoint, but a concurrent extended electroencephalogram montage showed frequent epileptiform discharges from the right parietal-temporal region and two electroclinical seizures arising from the right-frontal-central-temporal region during sleep. Magnetic resonance imaging scan revealed a right parasagittal parietal region lesion consistent with a low-grade neoplasm, and surgical resection of the lesion demonstrated a right parietal dysembryoplastic neuroepithelial tumor. Complex partial seizures and sleepwalking remitted completely with anticonvulsant therapy following surgery.

CONCLUSIONS

This patient highlights the differential diagnosis of nocturnal events appearing to be typical parasomnias, especially when they arise abruptly at an older age.

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