Paradoxical Kinesia Induced by Nightmare: Unique Case Report and Insights regarding the Neural Mechanism Based on Human and Rat Studies.
Level 4 - case-series / case-control
Single case report
PubMed 39015831 · doi:10.1159/000539548
What was done
The authors describe a single case of a patient with advanced Parkinson's disease who exhibited paradoxical kinesia during a nightmare, and propose a theoretical neural mechanism based on human and animal literature.
What was found
No quantitative data were reported in the abstract. A patient with advanced Parkinson's disease, cognitive decline, visual impairment, and severe motor impairment (inability to rise from bed or walk) was able to get out of bed and quickly run away unassisted during a nightmare episode.
Why it matters
This report identifies nightmares as a potential trigger for paradoxical kinesia in Parkinson's disease. It suggests that acute fear processed by the brain aversive system may temporarily activate motor output pathways that bypass impaired basal ganglia circuitry.
Limits
The report is based on a single patient (n = 1) without objective physiological sleep or kinematic measurements reported in the abstract. The proposed neural mechanism is entirely theoretical and not directly tested in this patient.
Cited by
- supports Individuals with Parkinson's disease experiencing akinesia or bradykinesia can suddenly execute rapid movements, such as running out of a burning house, when faced with an urgent emergency (kinesia paradoxa).