The pathogenesis of parasomnias (e.g., sleepwalking, enuresis, sleep talking) is variable and not well described and involves state dissociation, whereby two states of being overlap simultaneously. For example, abnormal activation of the central pattern generator of the spinal cord that produces motor movements is hypothesized to underlie sleepwalking behavior. In RBD, active inhibition of motor activity in the perilocus coeruleus region is lost, resulting in loss of paralysis and dream enactment.

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