Violent sleepwalking in a general hospital ward: a case report

Abstract

th night of bad sleep, A. stood up, started to vigorously batter another accompanying mother (Mrs. B.) with a blanket and tried to strangle her. The nurses found A. with a blank stare and tried to wake her up. A. was confused for about three minutes and started crying. Before the event, A. and B. had had a good relationship. Two days after this episode, A. was sleeping during the afternoon when she suddenly stood up and vigorously shook her daughter’s bassinet being witnessed by other person in the ward. After wakening up the confused mother, the psychiatric consultationliaison was called. A. vaguely remembered fragmentary dream images of a fight for her life at the first event and an assault attempt at the second. She denied previous major psychiatric disorders or treatment, seizures, use of medication, alcohol or drugs abuse but affirmed SW through her eleven to thirteen years of age. Since ten months after her husband’s death, A. had had repeated screaming night arousals. She presented with mild anxiety symptoms and normal EEG. Clonazepam 1mg per night was prescribed, with good improvement of sleep and no recurrence of confusional arousals. Her 16-channel polysomnographic study revealed only fragmented sleep with excessive movements on the bed, but inconclusive for parasomnias.