A 72-year-old man with a 30-year complaint of intractable insomnia had a positive family history of depression. He first came to psychiatric attention in 1958, after attacking his wife. He was prescribed barbiturates, and later was given meprobamate and nitrazepam, but with no effect on his complaint. The patient tended to increase the dosage of any drug given, of his own accord. EEG sleep recording confirmed the diagnosis of nocturnal myoclonus. It was hoped that at the case conference further treatment stratagems would be suggested.
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