Dados do Trabalho

Título

Correlation between sleep paralysis and frontal lobe tumor

Introdução

Sleep paralysis (SP) involves a period of inability to perform voluntary movements at the onze of sele o no awakening.

Objetivo

To describe a clinical case about the correlation between sleep paralysis and frontal lobe tumor, as well as to perform a brief literature review.

Métodos

Qualitative and individualized analysis of a rare clinical case on brain neoplasia-related sleep disorder, following the patient's evolution from diagnosis, therapy and prognosis.

Resultados

A 24-year-old male patient complains of an early feeling of suffocation on sleep, with difficulty waking up in these episodes since two months ago. He reported that at sleep he felt paralysis of the body and the sensation of trying to move, scream and fail. Initially it was indicative of apnea, reflux or sleep paralysis. Polysomnography detected moderate apnea. Upper digestive endoscopy found erosive reflux esophagitis. After treatment, on return patient reported worsening sleep paralysis and was prescribed benzodiazepine without improvement after 30 days. Thus, a magnetic resonance imaging of the brain was requested, which showed expansive lesion with infiltrative characteristics of the right frontal lobe. He was referred for neurosurgery and tumor resection was performed. Pathological examination revealed morphological pattern compatible with grade 2 diffuse astrocytoma. After tumor removal the patient did not have sleep paralysis again.The etiology of sleep paralysis tends to be multifactorial: hereditary factors, physical health problems, stress and trauma may develop. And it also appears to be associated with posttraumatic stress disorder (PTSD), narcolepsy and panic attacks.The pathophysiology of sleep paralysis is due to faulty brainstem structures. This paralysis is a result of skeletal muscle tone suppression by the pons and ventromedial cord, exerted by the γ-aminobutyric acid and glycine neurotransmitters, which inhibit the motor neurons of the spinal cord. Brain lobes are interconnected, so any damage to their structure can lead to changes in behavior. The frontal lobe is responsible for social behavior and motor planning. Therefore, an injury to the frontal cortex can lead to paresis.

Conclusões

It is relevant to highlight the scarcity in the literature of the correlation between sleep paralysis and frontal lobe tumor, as well as the rarity of identifying similar clinical cases.

Palavras-chave

apnea, sleep paralysis, frontal lobe tumor.