When Waking Up Becomes the Nightmare: Hypnopompic Hallucinatory Pain

In conclusion, to our knowledge this is the first report of a NREM parasomnia associated with painful paroxysms, for which we postulate the following underlying pathophysiological mechanism: an internal or external stimulus triggers arousal, facilitating the activation of innate motor pattern generators in the brainstem and activating somatosensory cortical areas to produce hypnopompic hallucinatory pain.So instead of the more typical visual hallucinations, the patient experiences pain hallucinations that originate.... where?? It seems to me that the sleep EEG could be analyzed more thoroughly, beyond merely ruling out seizure occurrence. Perhaps another imaging modality like PET could be tried (PET would be quieter than fMRI and would better tolerate movement). Identifying the neurophysiological correlates of her phantom night terror pain would provide a fascinating glimpse into a highly unusual sensory phenomenon.2Further ReadingThe Phenomenology of Pain During REM SleepThe Neurophysiology of Pain During REM SleepFootnotes1 The questions asked in the telephone interviews by Ohayon et al. (1996) were:(a) Do you experience at least twice a week the following perceptions?(i) the realistic feeling that someone or something is present in the room(ii) a vivid experience of being caught in a fire(iii) a vivid experience that you are about to be attacked(iv) a vivid experience that you are flying through the air(v) the feeling that you will soon fall into an abyss(vi) the feeling t...
Source: The Neurocritic - Category: Psychiatrists and Psychologists Authors: Source Type: blogs