A 12-year-old girl is brought to the office by her mother due to unusual nighttime behavior. The mother reports that once or twice a month over the past year she has found her daughter walking around the house between the hours of midnight and 2 AM. The mother says, "Although her eyes are open, she appears to be in a daze and doesn't respond to me. I guide her back to bed and she goes back to sleep, but I worry that she could get hurt or fall down the stairs if I'm not there." The girl has no recollection of the events. Which of the following EEG patterns is characteristic of the sleep stage associated with this behavior?

Question

A 12-year-old girl is brought to the office by her mother due to unusual nighttime behavior.  The mother reports that once or twice a month over the past year she has found her daughter walking around the house between the hours of midnight and 2 AM.  The mother says, "Although her eyes are open, she appears to be in a daze and doesn't respond to me.  I guide her back to bed and she goes back to sleep, but I worry that she could get hurt or fall down the stairs if I'm not there."  The girl has no recollection of the events.  Which of the following EEG patterns is characteristic of the sleep stage associated with this behavior?

Quizplus · Accepted Answer

11ec160b_3b0d_e3fc_9249_2b92037c3c75_MD0001_00 This girl's nighttime ambulation associated with incomplete arousal and amnesia for the event is consistent with sleepwalking, a non-REM (NREM) parasomnia. Sleepwalking is more common in children, peaks at age 8-12, and often remits spontaneously. NREM-related parasomnias such as sleepwalking and sleep terrors occur during deep, slow-wave sleep. Deep, slow-wave sleep is more prominent during the first half of the night and, as a result, NREM-related parasomnias occur more commonly during this time. Sleep is divided into NREM and REM sleep. Most dreams occur during REM sleep. NREM sleep is further divided into 3 substages based on depth of sleep (N1, N2, and N3). Brain waves of different frequencies are associated with different stages of sleep. Delta waves (frequency up to 3.99 Hz) are characteristic of deep, slow-wave sleep (stage N3). Alpha and beta waves are characteristic of wakefulness and REM sleep (Choices A and B). K complexes and Sleep spindles are characteristic of stage N2 (light, stable sleep) (Choices D and E). Educational objective: Sleepwalking, a common non-REM parasomnia of childhood, occurs during slow-wave sleep (stage N3), which is characterized by delta waves on EEG. Sleepwalking typically occurs during the first half of the night, when slow-wave sleep is most prominent. __________ References: Electroencephalographic slow waves prior to sleepwalking episodes. (http://www.ncbi.nlm.nih.gov/pubmed/25454846) Non-rapid eye movement arousal parasomnias in children. (http://www.ncbi.nlm.nih.gov/pubmed/28892547) Prevalence of sleepwalking: a systematic review and meta-analysis. (http://www.ncbi.nlm.nih.gov/pubmed/27832078)

A 12-Year-Old Girl Is Brought to the Office by Her