PMC4820074_01
Peduncular hallucinosis and REM sleep behavior disorder associated with ischemic pontine infarction. In the left rostrodorsal pons, diffusion-weighted imaging (DWI) shows high signal and apparent diffusion coefficient (ADC) map reveals low signal suggestive of an acute ischemic stroke.
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F1
Structural brain MRI three days after the surgery showed restricted diffusion in the left rostrodorsal pons suggestive of an acute ischemic infarct (Fig.1).
Patient polysomnography during REM sleep. There is persistent muscle activity in chin (musculus masseter) and leg (tibialis anterior) EMG leads during REM sleep indicative of REM sleep without atonia.
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F2
REM sleep without atonia (RSWA) was observed on two in-hospital polysomnography studies (Fig. 2) consistent with a diagnosis of RBD.