The association of epileptic seizures with sleep has been recognized since antiquity. Sleep disturbance in patients with epilepsy may be related with the underlying seizure disorder itself, its therapy, or the presence of a sleep disorder such as obstructive sleep apnea. On the other hand, in some patients, seizures may be the underlying cause of symptoms that initially suggested a primary sleep disturbance.

The authors’ aim is to report a case of a 26-year-old male who presented to the hospital with symptoms suggestive of a mood disorder and a sleep disturbance, and was diagnosed with nocturnal complex partial seizures. A literature's review about the psychiatric manifestations of epilepsy was also made.

The patient is a 26-year-old single male who was referred to the psychiatric yard when he was 19 years-old because he exhibited depressed mood, social inhibition and complained of sleep disturbance. He explained that episodically he made rhythmic head movements to fall asleep, since he was a child. Laboratory tests with thyroid function were normal. Cranial tomography showed mild plagiocephaly with a slight deformation of the right parietal region. Magnetic resonance imaging was normal. Diurnal and nocturnal electroencephalogram (EEG) documented left frontotemporal paroxysmal activity with a tendency to generalize.Video-EEG polysomnogram revealed rhythmic head movements during REM sleep, without paroxysmal activity preceding the events, and reduced REM sleep.

Psychiatric conditions occur frequently in epilepsy and their manifestations are diverse. Clinicians should be aware of atypical presentations.