DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20164237

Extreme complication of somnambulism: death due to accidental fall from height

Shivkumar Rajshekhar Kolle, Vinod Ashok Chaudhari

Abstract


Somnambulism is NREM sleep disorder which associated with severe injuries and violence and even death. We reported an extreme complication of somnambulism i.e. death due accidental fall from height leading to head injury. Twenty-one-year-old male fell from a terrace of a three-storey residential building (13-14 meters) in the early morning. Police and relatives thought it to be suicidal or homicidal death. On inquiry, he had a history of somnambulism (SA) and sleep talking [somniloquy (SL)] since childhood. He never had severe injuries due to somnambulism except for minor injuries. Autopsy findings showed multiple comminuted fractures of the skull, but no evidence of long bone and spine fractures. Multiple graze abrasions on both the sheens, right knee, and toes; these were suggestive of brushing or hitting with enclosure wall of a terrace. Other injuries were suggestive of impact with the hard surface of ground. He died due to a complication of somnambulism, which was accidental in nature. We suggest safety practices, regular psychiatric and psychological assessment for a person suffering from somnambulism.


Keywords


Accidental, Fall from height, Sleepwalking, Somnambulism

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References


Gelder M, Gath D, Mayou R. Oxford textbook of psychiatry. 3rd ed. Oxford University Press. 1996:413.

Szucs A, Halasz P. Somnambulism: clinical and eletrophysiological aspects. Orvosi hetilap. 2005;146(23):1231-7.

Kaplan SBJ. Sadock's comprehensive textbook of psychiatry. 8th ed. Philadelphia, PA: lippincott Williams & Wilkins. 2005;2022-31.

Hughes JR. A review of sleepwalking (somnambulism): the enigma of neurophysiology and polysomnography with differential diagnosis of complex partial seizures. Epilepsy & Behavior. 2007;11(4):483-91.

Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL. Harrison's Principles of Internal Medicine. 16th ed. McGraw-Hill Professional. 2004.

Mahowald MW, Bundlie SR, Hurwitz TD, Schenck CH. Sleep violence-forensic science implications: polygraphic and video documentation. Journal of Forensic Science. 1990;35(2):413-32.

Lauerma H. Fear of suicide during sleepwalking. Psychiatry. 1996;59(2):206-11.

Broughton R, Billings R, Cartwright R, Doucette D, Edmeads J, Edwardh M, et al. Homicidal somnambulism: a case report. Sleep. 1994;17(3):253-64.

Mahowald MW, Schenck CH, Goldner M, Bachelder V, Cramer-Bornemann M. Parasomnia pseudo-suicide. J forensic Sci. 2003;48(5):1158-62.

Sillesen NH, Nielsen LT, Bonde C. Complex injuries associated with somnambulism. Ugeskrift for laeger. 2010;172(50):3489-90.