Journal
SLEEP
Volume 32, Issue 3, Pages 409-412Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/sleep/32.3.409
Keywords
Local arousal; NREM parasomnia; state dissociation; confusional arousal; stereo-EEG
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Study Objectives: Arousal parasomnias are expressions of sleep/wake state dissociations in which wakefulness and NREM sleep seem to coexist, We describe the results of a neurophysiological (intracerebral EEG) investigation that captured an episode of confusional arousal. Design: Observational analysis. Setting: Tertiary sleep center. Subject: A 20-year-old male with refractory focal epilepsy. Measurements and Results: The intracerebral EEG findings documented the presence of a local arousal of the motor and cingulate cortices associated with increased delta activity in the frontoparietal associative cortices; these findings were noted preceding the onset and persisting throughout the episode. Conclusions: The presence of dissociated sleep/wake states in confusional arousals is the expression not of a global phenomenon, but rather of the coexistence of different local states of being: arousal of the motor and cingulate cortices and inhibition of the associative ones. Whether this is an exclusive feature of NREM parasomnias, or a common substrate on which other triggering elements act, needs to be clarified.
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