A 64-Year-Old Man Is Brought to the Office for Assessment

A 64-year-old man is brought to the office for assessment of atypical sleep patterns. According to his wife, the patient has been striking at the pillow and shouting loudly while sleeping for the previous three months. When he awakens from these dreams, he recalls a distressing scenario in which he is pursued by enemies and either defend himself or flee. The episodes are generally little more than 1-2 minutes long. The vital indicators are within normal ranges. Examinations of general physical and mental condition reveal no anomalies. A proper sleep study (polysomnogram) has been requested. Which of the following is most likely to be discovered as a result of this testing?

A) Excessive, sustained muscle tone during REM sleep
B) Focal epileptic activity originating from the temporal lobe with secondary generalization
C) Focal, sharp epileptic activity originating from the frontal lobes
D) Mixture of wake-like and sleep-like states in different cortical regions in non-REM sleep
E) Sleep latency of less than 5 minutes and multiple sleep-onset REM periods

Correct Answer:

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