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Chapter 45 - Nocturnal wanderings and an arachnoid cyst

from Section 5 - Neuroimaging of sleep disorders

Published online by Cambridge University Press:  05 March 2013

By
Alejandro Jiménez-Genchi  and
Yazmín de la Garza-Neme
Edited by
Eric Nofzinger ,
Pierre Maquet  and
Michael J. Thorpy
Eric Nofzinger
Affiliation:
University of Pittsburgh
Pierre Maquet
Affiliation:
Université de Liège, Belgium
Michael J. Thorpy
Affiliation:
Sleep-Wake Disorders Center, Montefiore Medical Center, New York
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Summary

This chapter focuses on the neuroimaging of nocturnal wanderings and an arachnoid cyst (AC) using a case of 15-year-old boy with a negative family and personal history for sleep, psychiatric, and epileptic disorders as an example. A few months after the first episode, he presented with urinary sphincter relaxation during an event, and also he experienced absence seizures. Interictal 99m technetium ethyl cysteinated dimer single-photon emission computed tomography (99mTc-ECD SPECT) scan showed impaired brain perfusion in the left temporal region (coronal view), corresponding with the AC found in magnetic resonance imaging (MRI). Based on clinical findings and the results of MRI, SPECT, and polysomnography (PSG), the authors have adopted a conservative approach. The patient was initially treated with magnesium valproate; however, a striking remission of attacks was observed when levetiracetam was added.

Keywords

sleep disordered breathingtreatment modalitiesupper airway imagingobstructive sleep apneaairway collapsibilityMRI
Type
Chapter
Information
Neuroimaging of Sleep and Sleep Disorders , pp. 352 - 354
Publisher: Cambridge University Press
Print publication year: 2013

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