Abstract

EB is a 22-year-old Caucasian woman requesting evaluation for a 2-year history of “spells of paralysis.” These began after an auto accident that was not associated with head trauma, but did result in a broken ankle. She described the accident as intensely terrifying. During recovery, she began having episodes of emerging from sleep to a state of being fully awake but unable to move, accompanied by a sense of fear and breathlessness. Sometimes, she would have visual imagery or strange sensations, such as feeling a distinct foreign presence in the room, seeing shadows, or hearing footsteps. Typically, episodes would occur from a nocturnal awakening, and could happen at any time of night. Initially, they would occur at random, from weekly, to a month or two apart. For the preceding month, events increased to several times a night and occurred during daytime napping. She became fearful of sleeping. She admitted reluctance to discuss these events with a physician for fear of being labeled mentally ill.

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