Sleep-wake pattern following gunshot suprachiasmatic damage

J Clin Sleep Med. 2014 Apr 15;10(4):443-5. doi: 10.5664/jcsm.3628.

Abstract

Background: The suprachiasmatic nucleus (SCN) plays a critical role in maintaining melatonin and sleep-wake cycles.

Methods/patient: We report a case of 38-year-old woman who, after gunshot wound to the right temple, developed a sleep complaint of multiple nocturnal awakenings and several naps throughout the day.

Results: Computerized tomography and magnetic resonance imaging revealed bilateral optic nerve and optic chiasm damage. Diagnostic polysomnography and actigraphy revealed an irregular sleep wake rhythm.

Conclusions: We speculate concurrent damage of the SCN and optic nerves bilaterally resulted in the posttraumatic irregular sleep-wake rhythm.

Keywords: Circadian rhythm sleep disorder; irregular sleep wake rhythm; suprachiasmatic nucleus.

Publication types

  • Case Reports

MeSH terms

  • Actigraphy
  • Adult
  • Brain / diagnostic imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Neuroimaging
  • Polysomnography
  • Sleep Disorders, Circadian Rhythm / diagnosis
  • Sleep Disorders, Circadian Rhythm / diagnostic imaging
  • Sleep Disorders, Circadian Rhythm / etiology*
  • Suprachiasmatic Nucleus / diagnostic imaging
  • Suprachiasmatic Nucleus / injuries*
  • Tomography, X-Ray Computed
  • Wounds, Gunshot / complications*
  • Wounds, Gunshot / diagnostic imaging