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  1. A polysomnographically documented case of adult somnambulism with long-distance automobile driving and frequent nocturnal violence : parasomnia with continuing danger as a noninsane automatism ?

    Article - En anglais

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0036505

    Code Inist : 002B30A10. Création : 01/03/1996.