This chapter discusses the case of a 42-year-old man who presented with a 2-year history of events of yelling and fighting in his sleep that were brought to his attention by his wife. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. When evaluating patients with nocturnal events, clinicians may find a sleep diary helpful in defining the frequency and behavioral characteristics. Further evaluation by video- polysomnography (PSG) is indicated for individuals with potential for injury, atypical features or symptoms of other sleep disorders. For events of much lower frequency, a video-PSG with full EEG recording would have provided some information regarding the presence of interictal discharges and other potential sleep disorders (such as obstructive sleep apnea (OSA)). When studies show no disorder, a therapeutic trial with antiepileptic medication may be considered.