Many of the parasomnias are manifestations of central nervous system activation and autonomic nervous system changes with skeletal muscle activity. Parasomnias can contribute to impaired academic or occupational performance, disturbances of mood and social adjustment. Identification of the presence of any psychological trauma or history of such trauma is important when trying to understand the possible sources of parasomnia. There is a predisposition to sleep-related dissociative disorder in victims of physical or sexual abuse or post-traumatic stress disorder (PTSD). Secondary sleep enuresis is also noted in these patients. This chapter begins with a thorough history-taking, keeping in mind the Parasomnia Classification in the International Classification of Sleep Disorders, 2nd edition (ICSD-2) and the differential diagnosis of abnormal behaviors and events during sleep. Seizures should always be considered in the differential of parasomnias, and formal EEG studies should be performed with appropriateness.