title: Differential diagnoses of nocturnal fear and movement paroxysm: a case report.
abstract: Recurrent nocturnal behavioural and movement paroxysms are a diagnostic challenge for the clinical pediatrician. We report on an adolescent girl who presents recurrent stereotypical nightmare-like episodes occurring during non-REM sleep stages 1-2 (N1 and N2). We discuss the differential diagnoses between epileptic and nonepileptic events and between nocturnal frontal and temporal seizures. The pathophysiological and unusual electroencephalographical features are discussed with respect to clinical features and results of interictal FDG-PET. Conclusion In case of stereotypical nightmare-like episodes in children or adolescents, an epileptic origin has to be ruled out before a parasomnia is diagnosed. In addition, a normal awake EEG or interictal sleep EEG in the diagnostic workup may not exclude an epileptic disorder. In case of nightly stereotypic motor or affective events, an epileptic disorder should be discussed.
authors.affiliation: Division Neuropediatrics and Developmental Medicine, University Children's Hospital Basel, Spitalstr. 33, 4056 Basel, Switzerland. Peter.Weber@ukbb.ch
authors.forename: Peter
authors.initials: P
authors.lastname: Weber
authors.forename: Freimut
authors.initials: F
authors.lastname: Jüngling
authors.forename: Alexandre Niklaus
authors.initials: AN
authors.lastname: Datta
mesh_terms: D000293:Adolescent; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020184:Night Terrors / Q000175:diagnosis*; D020183:Nocturnal Paroxysmal Dystonia / Q000175:diagnosis*