• neurinoma
• sleep behaviour disorder

REM sleep behaviour disorder (RBD) is a type of parasomnia described by Schenck et al.^{1, 2} It is manifested by vigorous body movements, vocalisation, and sometimes injurious behaviour occurring during vivid and violent dreams. Polysomnographic recordings show abnormal abolition of the generalised muscle atonia that occurs during REM sleep, and concurrent bursts of muscle twitching in the absence of epileptic activity.¹ There is experimental evidence^{3, 4} that the area of the brain stem, and especially the pontine tegmentum, is involved in the pathogenesis of the disorder.⁴ We report a patient who presented with RBD and was diagnosed and treated for a brain stem neurinoma.

The patient is a 59 year old man, an ex-sailor, who was referred to our clinic because of vivid dreams accompanied by violent behaviour during sleep. He described dreams during which he was trying to defend himself while he was threatened by strangers or attacked by animals. Enacting his dreams, he swore at his “enemies,” and punched and kicked his bed partner. He had repeatedly injured himself crashing into objects or falling out of bed. …