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

Case 27 - Sleepwalking or seizing?

from Part V - Sleep-related epilepsy

Summary

This chapter presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on a 38-year-old female patient who was admitted to a university sleep disorders center to address amnestic nocturnal behavior. She was a friendly, non-dysmorphic patient who cooperated throughout the examination. Her vital signs were normal except for a BMI of 26 kg/m2 and borderline systolic hypertension. Her mood and affect were bright and congruent. In particular, there was no evidence on examination of subtle changes suggestive of a dementing illness or a Parkinsonian syndrome. An EEG carried out in 2005 and 2009 demonstrated normal awake and drowsy responses. An MRI carried out in 2009 showed normal brain. Polysomnography (PSG) showed that sleep was initiated without a sedativehypnotic. A diagnosis was made of mixed NREM parasomnia characterized by confusional arousals, sleepwalking (with sleepdriving), sleep-related eating disorder, and sexsomnia exacerbated by zolpidem.

Suggested reading

Historical
GastautH, BroughtonR.Epileptic Seizures. Springfield, Illinois: Charles C Thomas; 1972.
Review
DykenME, YamadaT, Lin-DykenDC.Polysomnographic assessment of spells in sleep: nocturnal seizures versus parasomnias. Semin Neurol 2001; 21: 377–90.
General
AASM (American Academy of Sleep Medicine). International Classification of Sleep Disorders, 2nd edn.: Diagnostic and Coding Manual. Westchester, Illinois: American Academy of Sleep Medicine, 2005.
KlassDW.Electroencehalographic mechanisms of complex partial seizures. In: PenryJK, DalyDD, eds. Complex Partial Seizures and Their Treatment. New York: Raven Press; 1975: 113–40.
KlassDW, EspinosaRE, Fischer-WilliamsM.Analysis of concurrent electroencephalographic and clinical events occurring sequentially during partial seizures [Abstract]. Electroencephalogr Clin Neurophysiol 1973; 34: 728.

Historical

GastautH, BroughtonR.Epileptic Seizures. Springfield, Illinois: Charles C Thomas; 1972.

Review

DykenME, YamadaT, Lin-DykenDC.Polysomnographic assessment of spells in sleep: nocturnal seizures versus parasomnias. Semin Neurol 2001; 21: 377–90.

General

AASM (American Academy of Sleep Medicine). International Classification of Sleep Disorders, 2nd edn.: Diagnostic and Coding Manual. Westchester, Illinois: American Academy of Sleep Medicine, 2005.
KlassDW.Electroencehalographic mechanisms of complex partial seizures. In: PenryJK, DalyDD, eds. Complex Partial Seizures and Their Treatment. New York: Raven Press; 1975: 113–40.
KlassDW, EspinosaRE, Fischer-WilliamsM.Analysis of concurrent electroencephalographic and clinical events occurring sequentially during partial seizures [Abstract]. Electroencephalogr Clin Neurophysiol 1973; 34: 728.