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Somnambulism is NREM sleep disorder which associated with severe injuries and violence and even death. We reported an extreme complication of somnambulism i.e. death due accidental fall from height leading to head injury. Twenty-one-year-old male fell from a terrace of a three-storey residential building (13-14 meters) in the early morning. Police and relatives thought it to be suicidal or homicidal death. On inquiry, he had a history of somnambulism (SA) and sleep talking [somniloquy (SL)] since childhood. He never had severe injuries due to somnambulism except for minor injuries. Autopsy findings showed multiple comminuted fractures of the skull, but no evidence of long bone and spine fractures. Multiple graze abrasions on both the sheens, right knee, and toes; these were suggestive of brushing or hitting with enclosure wall of a terrace. Other injuries were suggestive of impact with the hard surface of ground. He died due to a complication of somnambulism, which was accidental in nature. We suggest safety practices, regular psychiatric and psychological assessment for a person suffering from somnambulism.
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