title: Sleep-wake pattern following gunshot suprachiasmatic damage.
abstract: BACKGROUND
  The suprachiasmatic nucleus (SCN) plays a critical role in maintaining melatonin and sleep-wake cycles.
  We report a case of 38-year-old woman who, after gunshot wound to the right temple, developed a sleep complaint of multiple nocturnal awakenings and several naps throughout the day.
  
  
  RESULTS
  Computerized tomography and magnetic resonance imaging revealed bilateral optic nerve and optic chiasm damage. Diagnostic polysomnography and actigraphy revealed an irregular sleep wake rhythm.
  
  
  CONCLUSIONS
  We speculate concurrent damage of the SCN and optic nerves bilaterally resulted in the posttraumatic irregular sleep-wake rhythm.
authors.affiliation: Division of Sleep Medicine, Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA ; Department of Family Medicine, Louisiana State University School of Medicine, Shreveport, LA.
authors.forename: Lourdes M
authors.initials: LM
authors.lastname: DelRosso
authors.affiliation: Division of Sleep Medicine, Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA.
authors.forename: Romy
authors.initials: R
authors.lastname: Hoque
authors.affiliation: Department of Family Medicine, Louisiana State University School of Medicine, Shreveport, LA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: James
authors.affiliation: Division of Sleep Medicine, Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA ; Department of Radiology, Louisiana State University School of Medicine, Shreveport, LA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gonzalez-Toledo
authors.affiliation: Division of Sleep Medicine, Department of Neurology, Louisiana State University School of Medicine, Shreveport, LA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Chesson
mesh_terms: D056044:Actigraphy; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging; D017286:Polysomnography; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D013493:Suprachiasmatic Nucleus / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000150:complications* / Q000000981:diagnostic imaging
keywords: Circadian rhythm sleep disorder; irregular sleep wake rhythm; suprachiasmatic nucleus
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