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Sonolência diurna excessiva pós-traumatismo de crânio: associação com movimentos periódicos de pernas e distúrbio de comportamento do sono REM: relato de caso

2002; Thieme Medical Publishers (Germany); Volume: 60; Issue: 3A Linguagem: Inglês

10.1590/s0004-282x2002000400028

1678-4227

Raimundo Nonato Rodrigues, Aída A.A. Abreu e Silva,

Traumatic Brain Injury Research

A 52 year-old male patient, had complaint of "restless sleep". His wife informed that for the past ten years the patient had presented intense and aggressive body movements, and sometimes, violent dreams. The patient also complained of excessive daytime sleepiness. His relevant previous medical history included a traumatic brain injury at the age of 28 which left him in coma for two months. A video-polysomnography showed periodic leg movements and, during REM sleep, aggressive and agitated behaviour. The multiple sleep latency test revealed extremely short latencies. Initially, he was treated with levodopa-benzerazide, 100/25 mg, 2 hours before bedtime. After 10 weeks his overnight behaviour pattern improved and leg movements diminished. This case supports the hypothesis of an association between cranial trauma and alterations in the dopaminergic pathways represented by periodic leg movements during sleep and a sleep behaviour disorder and proposes the possibility of hypothalamic hypocretin involvement in its pathophysiology.