Night terrors associated with thalamic lesion

Objective: To describe a case with night terrors (NT) symptomatic of a thalamic lesion. Methods: Videopolysomnography and brain MRI were used to study a 48 year old woman with a recent onset of brief episodes, occurring exclusively during nocturnal sleep, where she suddenly sat up in bed, screamed and appeared to be very frightened. Results: Videopolysomnography recorded an episode suggestive of NT. Sleep fragmentation with frequent brief arousals or microarousals was also evident mainly during slow wave sleep. The brain MRI showed increased T2 signal from the right thalamus suggestive of a low-grade tumor. Conclusions: Our case suggests that NT starting in adulthood can, rarely, be symptomatic of neurological disease, and warrant further investigation with MRI. Significance: A thalamic dysfunction, disrupting at this level the arousal system, may play a role in provoking NT.