Visual hallucinations and pontine demyelination in a child: possible REM dissociation?

Giacomo Della Marca, Maria Gabriella Vita, Anna Paola Batocchi, Serena Dittoni, Maria Chiara Stefanini, Catello Vollono, Paolo Mariotti, Alessandro Cianfoni

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4 Citazioni (Scopus)

Abstract

An 11 year-old-boy acutely developed complex visual and acoustic hallucinations. Hallucinations, consisting of visions of a threatening, evil character of the Harry Potter saga, persisted for 3 days. Neurological and psychiatric examinations were normal. Ictal EEG was negative. MRI documented 3 small areas of hyperintense signal in the brainstem, along the paramedian and lateral portions of pontine tegmentum, one of which showed post-contrast enhancement. These lesions were likely of inflammatory origin, and treatment with immunoglobulins was started. Polysomnography was normal, multiple sleep latency test showed a mean sleep latency of 8 minutes, with one sleep-onset REM period. The pontine tegmentum is responsible for REM sleep regulation, and contains definite "REM-on" and "REM-off" regions. The anatomical distribution of the lesions permits us to hypothesize that hallucinations in this boy were consequent to a transient impairment of REM sleep inhibitory mechanisms, with the appearance of dream-like hallucinations during wake
Lingua originaleEnglish
pagine (da-a)588-590
Numero di pagine3
RivistaJournal of Clinical Sleep Medicine
Stato di pubblicazionePubblicato - 2008

Keywords

  • REM
  • child
  • demyelination

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