Nocturnal Paroxysmal Motor Phenomena

Episodic Nocturnal Wanderings

Diurnal Paroxysmal Dyskinesias Responsive to Anticonvulsants Hypnogenic Paroxysmal Dystonia or Epilepsy? Other Sleep-Related Paroxysmal Events Nocturnal Frontal Lobe Epilepsy Autosomal Dominant Frontal Lobe Epilepsy Summary References nocturnal paroxysmal motor phenomena

The nature of paroxysmal motor phenomena occurring during sleep has been a matter of debate for many years. Various sleep disorders associated with motor activity such as sleepwalking (somnambulism), sleep talking, night terrors (pavor nocturnus), periodic limb movement disorder, and rapid eye movement (REM)

Epilepsy and Sleep: Physiological and Clinical Relationships

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behavior disorder (RBD) have been described and constitute well-recognized entities (ICSD, 1990). Epileptic motor seizures may manifest themselves at any time of the day or night. However, some types of seizures, especially those originating from the mesial or orbitofrontal region, preferably occur during sleep (Niedermeyer and Walker, 1971; Tharp, 1972; Waterman et al., 1987); have a peculiar semiology characterized by complex movements with dystonic, choreic, or ballistic features, asymmetrical tonic postures, and bizarre vocalizations, often with preserved consciousness (Tharp, 1972; Talairach et al, 1973; Geier et al., 1977; Bancaud and Talairach, 1992; Salanova et al., 1995); and are not always associated with epileptiform abnormalities on scalp EEG (Williamson et al., 1985; Morris et al., 1988), thus leaving room for diagnostic uncertainties. In addition, Tassinari and colleagues (1972) have pointed out that true parasomnias may coexist in patients with known epilepsy.

However, some nocturnal motor events do not fit readily into any of these categories.

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