Sleep-wake pattern following gunshot suprachiasmatic damage.

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.