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  • Print publication year: 2010
  • Online publication date: November 2010

Case 28 - Seizure, parasomnia or behavioral disorder?

from Part V - Sleep-related epilepsy


This chapter discusses the case of a 48-year-old woman who was having episodes of sitting upright in bed, letting out a blood curdling scream and patting the bed with both hands, and often going back to sleep without realizing what had happened. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. The specialist ordered an MRI of the brainwith special thin cuts through the frontal and temporal lobes, and nocturnal polysomnography (PSG) with an additional all-night 16-channel EEG running concomitantly with the PSG. Based on the results of the studies, a diagnosis of sleep terrors or disorder of partial arousal was made. She was prescribed clonazepam 0.5mg and was urged to follow up with the behavior therapist. Six months later, her events were all well controlled by the behavioral therapy recommendations.

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DykenME, YamadaT, Lin-DykenDC.Polysomnographic assessment of spells in sleep: nocturnal seizures versus parasomnias. Semin Neurol 2001; 21: 377–90.
ProviniF, PlazziG, TinuperP, et al. Nocturnal frontal lobe epilepsy. A clinical and polygraphic overview of 100 consecutive cases. Brain 1999; 122: 1017–31.
RyvlinP, RheimsS, RisseG.Nocturnal frontal lobe epilepsy. Epilepsia 2006; 47: 83–6.
TaoJX, RayA, Hawes-EbersoleS, et al. Intracranial EEG substrates of scalp EEG interictal spikes. Epilepsia 2005; 46: 669–76.
TaoJX, BaldwinM, RayA, et al. The impact of cerebral source area and synchrony on recording scalp electroencephalography ictal patterns. Epilepsia 2007; 48: 2167–76.