Sleep state misperception: is there a CNS structural source?

• Published in: Sleep science (Sao Paulo, Brazil) Vol. 14; pp. 94 - 96
• Main Authors: Truzzi, Giselle de Martin, Teixeira, Igor de Lima, do Prado, Lucila Bizari Fernandes, do Prado, Gilmar Fernandes, Tufik, Sergio, Coelho, Fernando Morgadinho
• Format: Report
• Language: English
• Published: 01.01.2021
• ISSN: 1984-0659
• DOI: 10.5935/1984-0063.20200039

INTRODUCTIONWe describe a case of sleep state misperception in a patient with a neurotoxoplasmosis lesion in the left nucleocapsular region. CASE REPORTA 40-year-old female patient presented relating sleeplessness over the past 2 years, concurrent with progressive headaches, dizziness and motor and sensory deficits in the right upper and lower limbs. She had a history of AIDS, on irregular antiretroviral therapy and neurotoxoplasmosis. A polysomnography confirmed the hypothesis of sleep state misperception, and magnetic resonance imaging revealed a residual lesion in the left nucleocapsular region. CONCLUSIONDifferent models consider that the sleep state misperception could be correlated to structural abnormalities of the central nervous system. A recent study showed that the medial prefrontal cortex had a lower activation in patients with unrefreshing sleep due to chronic fatigue syndrome. This case report highlights the possibility of sleep state misperception having - at least partially - an anatomical substrate in the left nucleocapsular region.