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Academia Mexicana de Neurología, A.C.

2007, Number 1

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Rev Mex Neuroci 2007; 8 (1)

Behavior during sleep as epilepsy manifestation: a subject review

Jiménez-Genchi A, Medellín-Puyou S

Language: Spanish
References: 23
Page: 75-79
PDF size: 365.86 Kb.


ABSTRACT

Although a relationship between sleep and epilepsy is well recognized and some sleep related epileptic syndromes are better characterized, those epilepsies which manifest through motor behaviors during sleep are less known. This paper offers a brief review about the clinical, diagnostic and therapeutic aspects of seizures that manifest through complex motor behavior during sleep. In last two decades, three kind of seizures have been described: a) Episodic Nocturnal Wanderings are featured by complex behavior, which includes leaving the bed, walking, taking things and even violent behavior; b) Nocturnal Paroxysmal Dystonia consists of brief and highly stereotyped dystonic movements of head, trunk and limbs; and, c) Paroxysmal Arousals are episodes characterized by sudden eyes opening and facial expressions of fear or confusion. They are more frequent in men, with an onset between 10 and 20 years old. Clinical assessments, EEG and imaging studies use to be normal. The polysomnogram with audiovisual monitoring is necessary to document the disorder. Events are present during stage 2, 3 and 4 of non rapid eye movements sleep. The focus of epileptic activity is predominantly located in frontal lobe, but also, although less frequently, in temporal lobe. Treatment with antiepileptic drugs, especially carbamazepine, produces notable improvement. These sleep related motor behaviors should be taken into account during the assessment of typical parasomnias and diurnal excessive sleepiness.


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