Brain Tumor Presenting as Somnambulism in an Adolescent

• Published in: Pediatric neurology Vol. 49; no. 3; pp. 209 - 212
• Main Authors: Prashad, Priya S., MD, MSCE, Marcus, Carole L., MBBCh, Brown, Lawrence W., MD, Dlugos, Dennis J., MD, Feygin, Tamara, MD, Harding, Brian N., FRCPath, Heuer, Gregory G., MD, PhD, Mason, Thornton B. Alexander, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2013
• Subjects: Adolescence; Adolescent; Brain Neoplasms - complications; Electroencephalography; Humans; Magnetic Resonance Imaging; Male; Neurology; Pediatrics; Polysomnography; Somnambulism - etiology
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2013.04.022

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