Article Text

Unusual association of diseases/symptoms
Sleep disruption following paramedian pontine stroke
  1. Matteo Tosato1,
  2. Sara Aquila1,
  3. Giacomo della Marca2,
  4. Raffaele Antonelli Incalzi3,
  5. Giovanni Gambassi4
  1. 1
    Università Cattolica del Sacro Cuore, Centro di Medicina dell’Invecchiamento, Largo Agostino Gemelli 8, Rome 00168, Italy
  2. 2
    Università Cattolica del Sacro Cuore, Istituto di Neurologia, Largo Agostino Gemelli 8, Rome 00168, Italy
  3. 3
    Università Campus Biomedico, Divisione di Geriatria, Largo Agostino Gemelli 8, Rome 00168, Italy
  4. 4
    Università Cattolica del Sacro Cuore, Centro di Medicina dell’Invecchiamento, Largo Agostino Gemelli 8, Rome 00168, Italy
  1. Matteo Tosato, mtosato{at}gmail.com

Summary

Pontine structures are critical for the generation of rapid eye movement sleep but there are only a few reports of the effects of focal pontine lesions on sleep patterns in humans. We report the case of an 81-year-old man admitted for the acute onset of disordered speech and motor deficit in the upper right arm who developed hypersomnia within a week. A 24-hour polysomnographic study revealed a very severe disruption of both circadian rhythm and sleep organisation, and a brain MRI documented an ischaemic lesion of the anterior left paramedian portion of the pons. Our observation suggests that even small, paramedian pontine ischaemic lesions can acutely induce a very severe sleep disorder.

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Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.

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