title: Movement disorders in sleep: guidelines for differentiating epileptic from non-epileptic motor phenomena arising from sleep.
abstract: Seizures, namely in certain epileptic conditions, may be precipitated by sleep. Nocturnal frontal lobe epilepsy seizures, characterized by bizarre motor behaviour and autonomic activation, appear almost exclusively during sleep. The differential diagnosis between this condition and sleep-related non-epileptic paroxysmal motor phenomena, in particular the parasomnias, is arduous. Moreover, accepted criteria for the diagnosis of nocturnal frontal lobe seizures are lacking and even ictal scalp EEG recording could fail to disclose paroxysmal abnormalities. The clinical and polygraphic features of the different types of seizures in nocturnal frontal lobe epilepsy and of the more common non-epileptic paroxysmal events during sleep are described. The main differentiating features characterizing nocturnal frontal seizures are: onset at any age, several attacks per night at any time during the night, brief duration (s) with stereotyped motor pattern. As video-polysomnographic recordings of the attack, the gold-standard for diagnosis, are expensive and not readily available everywhere, home-made video recordings may be helpful. Further investigations on pathophysiology, genetics and epidemiology are needed to clarify the relationship between epileptic and non-epileptic sleep related paroxysmal phenomena.
authors: Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy. paolo.tinuper@unibo.it
authors: Paolo
authors: P
authors: Tinuper
authors: Federica
authors: F
authors: Provini
authors: Francesca
authors: F
authors: Bisulli
authors: Luca
authors: L
authors: Vignatelli
authors: Giuseppe
authors: G
authors: Plazzi
authors: Roberto
authors: R
authors: Vetrugno
authors: Pasquale
authors: P
authors: Montagna
authors: Elio
authors: E
authors: Lugaresi
mesh_terms: D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis*; D006801:Humans; D020183:Nocturnal Paroxysmal Dystonia / Q000175:diagnosis*; D020447:Parasomnias / Q000175:diagnosis*; D017286:Polysomnography / Q000379:methods; D017410:Practice Guidelines as Topic; D012640:Seizures / Q000175:diagnosis*; D020921:Sleep Arousal Disorders / Q000175:diagnosis; D014743:Videotape Recording