A polysomnographically documented case of adult somnambulism with long-distance automobile driving and frequent nocturnal violence : parasomnia with continuing danger as a noninsane automatism ?
A case of childhood-onset somnambulism is reported in which a 43-year-old man presented with repeated sleep-related injuries incurred during violent nocturnal activity, which included frenzied running throwing punches and wielding knives.
He had also driven an automobile a long distance during a presumed somnambulistic state.
His wife had been repeatedly injured, and she felt that her life was threatened by his nocturnal violence 2-3 times yearly.
Polysomnography (PSG) documented multiple episodes of complex and violent behaviors arising exclusively from stage 3/4 sleep, thus confirming the diagnosis of somnambulism.
Other causes of sleep-related violence were excluded.
The patient responded promptly to treatment with bedtime clonazepam, and benefit was maintained at 5-year follow-up.
Although this strictly clinical case did not have any legal repercussions, it does carry forensic implications, particularly when placed in the context of the published medical literature on PSG-documented parasomnias (somnambulism, rapid eye movement sleep behavior disorder) containing explicit examples of recurrent violence, at times life-threatening, directed toward the bed partner and others.
Thus, a new medical-legal concept is proposed, consisting of « parasomnia with continuing danger » as a noninsane automatism.
Treatment guidelines, within the context of forensic medicine, are presented.
Mots-clés Pascal : Violence, Nuit, Conduite véhicule, Longue distance, Exploration, Electroencéphalographie, Electrocardiographie, Electromyographie, Somnambulisme, Aspect médicolégal, Stade sommeil, Etude cas, Homme, Vigilance, Electrophysiologie, Système nerveux pathologie, Trouble neurologique, Trouble sommeil
Mots-clés Pascal anglais : Violence, Night, Vehicle driving, Long distance, Exploration, Electroencephalography, Electrocardiography, Electromyography, Somnambulism, Forensic aspect, Sleep stage, Case study, Human, Vigilance, Electrophysiology, Nervous system diseases, Neurological disorder, Sleep disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0036505
Code Inist : 002B30A10. Création : 01/03/1996.