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CC BY-NC-ND 4.0 · Sleep Sci 2021; 14(S 01): 94-96
DOI: 10.5935/1984-0063.20200039
CASE REPORT

Sleep state misperception: is there a CNS structural source?

Giselle de Martin Truzzi
1   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - Brazil.
,
Igor de Lima Teixeira
2   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia - São Paulo - Brazil.
,
Lucila Bizari Fernandes do Prado
2   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia - São Paulo - Brazil.
,
Gilmar Fernandes do Prado
2   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia - São Paulo - Brazil.
,
Sergio Tufik
1   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - Brazil.
,
Fernando Morgadinho Coelho
1   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - Brazil.
2   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia - São Paulo - Brazil.
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ABSTRACT

Introduction: We describe a case of sleep state misperception in a patient with a neurotoxoplasmosis lesion in the left nucleocapsular region.

Case report: A 40-year-old female patient presented relating sleeplessness over the past 2 years, concurrent with progressive headaches, dizziness and motor and sensory deficits in the right upper and lower limbs. She had a history of AIDS, on irregular antiretroviral therapy and neurotoxoplasmosis. A polysomnography confirmed the hypothesis of sleep state misperception, and magnetic resonance imaging revealed a residual lesion in the left nucleocapsular region.

Conclusion: Different models consider that the sleep state misperception could be correlated to structural abnormalities of the central nervous system. A recent study showed that the medial prefrontal cortex had a lower activation in patients with unrefreshing sleep due to chronic fatigue syndrome. This case report highlights the possibility of sleep state misperception having - at least partially - an anatomical substrate in the left nucleocapsular region.

Keywords:

Sleep - Toxoplasmosis, Cerebral - Sleep Initiation and Maintenance Disorders - Acquired Immunodeficiency Syndrome


Publication History

Received: 21 June 2018

Accepted: 17 November 2018

Article published online:
30 November 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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