-
The Journal of Neuroscience Nursing :... Feb 2021BACKGROUND: Sleep-related hypermotor epilepsy (SHE) and nocturnal non-rapid eye movement parasomnias are difficult to differentiate. Neurologists and sleep medicine...
BACKGROUND: Sleep-related hypermotor epilepsy (SHE) and nocturnal non-rapid eye movement parasomnias are difficult to differentiate. Neurologists and sleep medicine clinicians largely rely on clinical history when evaluating nocturnal spells. When the diagnosis is in question, referral for video electroencephalogram monitoring is the standard. However, there are no guidelines as to when this evaluation is needed. The Frontal Lobe Epilepsy Parasomnia (FLEP) scale was developed to assist clinicians in differentiating the two among adults. The aim of this study was to provide a preliminary evaluation of the FLEP for use with children. METHODS: This was a retrospective pilot instrument validation study with a convenience sample of 17 children seen in neurology or sleep medicine clinics. To determine concurrent validity, FLEP scores were compared with clinical diagnoses by neurology providers confirmed by electroencephalography. RESULTS: With a cutoff score of 2, the modified FLEP distinguished between children with and without SHE. The FLEP tool had a specificity of 0.58, implying that 7 of the 12 children without SHE would have been accurately recommended to follow up for parasomnia management rather than more urgent evaluation of potential frontal lobe epilepsy. CONCLUSIONS: With some minor adaptations for children, the FLEP satisfactorily distinguished between SHE and non-SHE patients.
Topics: Adult; Child; Electroencephalography; Epilepsy, Frontal Lobe; Humans; Parasomnias; Polysomnography; Retrospective Studies; Sleep Wake Disorders
PubMed: 33298683
DOI: 10.1097/JNN.0000000000000567 -
Journal of Forensic Sciences May 2022
Commentary on: Munro NA. Alcohol and parasomnias: The statistical evaluation of the parasomnia defense in sexual assault, where alcohol is involved. J Forensic Sci. 2020;65(4):1235-41. doi: 10.1111/1556-4029.14322.
Topics: Ethanol; Humans; Parasomnias; Sex Offenses
PubMed: 35187656
DOI: 10.1111/1556-4029.14981 -
Medical Hypotheses Jul 2014To characterize a subgroup of arousal parasomnias associated with violent behavior in adults.
OBJECTIVE
To characterize a subgroup of arousal parasomnias associated with violent behavior in adults.
DESIGN
A pilot study on clinical and polysomnographic data of 13 adult patients seen in a tertiary sleep center for the suspicion of arousal parasomnia associated with violence.
RESULTS
Nine young patients (8 males 1 female) had a common pattern of abnormalities: similar 'claustrophobic' dream-like experiences and complex, vehement dream enactments; no REM sleep without atonia on polysomnography. We call this syndrome 'violent somnambulism'. The rest of the patients had alcoholic delirium, partial epilepsy, possible REM sleep behavior disorder and a single sleep walking episode provoked by a sleeping pill.
CONCLUSIONS AND HYPOTHESIS
Sleep related violence needs thorough diagnostic evaluation for preventing life-threatening consequences. Violent somnambulism appears to be a distinct NREM sleep-related overlap parasomnia.
Topics: Female; Humans; Male; Sleep, REM; Somnambulism; Violence
PubMed: 24831087
DOI: 10.1016/j.mehy.2014.04.012 -
Brain : a Journal of Neurology Dec 2010Although generally considered as mutually exclusive, violence and sleep can coexist. Violence related to the sleep period is probably more frequent than generally... (Review)
Review
Although generally considered as mutually exclusive, violence and sleep can coexist. Violence related to the sleep period is probably more frequent than generally assumed and can be observed in various conditions including parasomnias (such as arousal disorders and rapid eye movement sleep behaviour disorder), epilepsy (in particular nocturnal frontal lobe epilepsy) and psychiatric diseases (including delirium and dissociative states). Important advances in the fields of genetics, neuroimaging and behavioural neurology have expanded the understanding of the mechanisms underlying violence and its particular relation to sleep. The present review outlines the different sleep disorders associated with violence and aims at providing information on diagnosis, therapy and forensic issues. It also discusses current pathophysiological models, establishing a link between sleep-related violence and violence observed in other settings.
Topics: Dissociative Disorders; Epilepsy; Forensic Medicine; Humans; Parasomnias; Polysomnography; Sleep Arousal Disorders; Sleep Wake Disorders; Sleep, REM; Violence
PubMed: 21126993
DOI: 10.1093/brain/awq296 -
Current Opinion in Neurology Apr 2011There is a complex relationship between epilepsy, sleep and sleep disorders. Recent studies have provided new insights into the links between the disorders that may... (Review)
Review
PURPOSE OF REVIEW
There is a complex relationship between epilepsy, sleep and sleep disorders. Recent studies have provided new insights into the links between the disorders that may facilitate differential diagnosis and treatment but may also improve our understanding of underlying pathophysiological mechanisms.
RECENT FINDINGS
Sleep and sleep deprivation have long been recognized to influence interictal epileptiform discharges and seizures. More recent studies have shown that primary sleep disorders such as obstructive sleep apnoea may worsen epilepsy and treatment of these sleep disorders can lead to improved seizure control. Seizures may interfere with night-time sleep structure and cause excessive day-time somnolence (EDS). Antiepileptic drugs may also cause EDS or influence sleep. Despite more frequent use of video-electroencephalographic telemetry and polysomnography, the differential diagnostic challenges between nonrapid eye movement parasomnia and nocturnal frontal lobe epilepsy remain. There is also ongoing debate regarding the possibility of a common pathogenic background for parasomnias and nocturnal seizures that is summarized in the review.
SUMMARY
Accurate identification and diagnosis of sleep disorders as well as epilepsy is clinically important to ensure optimal treatment of both epilepsy and sleep disorders. Further studies of these nocturnal events may advance our understanding of underlying pathological mechanisms and the complex relationship between sleep and epilepsy.
Topics: Anticonvulsants; Diagnosis, Differential; Epilepsy; Humans; Parasomnias; Sleep; Sleep Wake Disorders
PubMed: 21386677
DOI: 10.1097/WCO.0b013e3283445355 -
Annals of Clinical and Translational... Sep 2019We report sleep phenotypes and polysomnographic findings in two siblings with a novel homozygous variant of the GLRA1 gene causing hereditary hyperekplexia (HH). Both...
We report sleep phenotypes and polysomnographic findings in two siblings with a novel homozygous variant of the GLRA1 gene causing hereditary hyperekplexia (HH). Both sisters had startles during wakefulness and sleep, sleep terrors, and one had symptoms of REM sleep behavior disorder (RBD). Frequent startles were found in NREM sleep associated with NREM parasomnias in deep sleep. In REM sleep, both had motor behaviors and increased phasic/tonic muscle activities confirming RBD. Clonazepam improved startles, motor behaviors, and muscle activities in REM sleep. Impaired glycinergic transmission in human HH could be involved in the pathophysiology of RBD and NREM parasomnias.
Topics: Adolescent; Adult; Female; Humans; Hyperekplexia; Parasomnias; Polysomnography; REM Sleep Behavior Disorder; Receptors, Glycine; Reflex, Startle; Siblings; Sleep
PubMed: 31392847
DOI: 10.1002/acn3.50866 -
Sleep Medicine Clinics Jun 2021This article is a comprehensive review of the clinical evaluation of sleep-related movement disorders. In this review, the authors present a practical approach to help... (Review)
Review
This article is a comprehensive review of the clinical evaluation of sleep-related movement disorders. In this review, the authors present a practical approach to help clinicians identify the "pattern recognition" of movement and behavior disorders during sleep, with the process of translating a particular movement that occurs when asleep, with clinically classifying disorders, and with obtaining an etiologic diagnosis. The aim is not to provide an exhaustive review of the literature, but to concentrate on the most important symptoms, so the clinical approach can be improved and the best choices can be made during the diagnostic process.
Topics: Humans; Parasomnias
PubMed: 33985649
DOI: 10.1016/j.jsmc.2021.02.001 -
Missouri Medicine 2018Parasomnias are abnormal and undesirable behaviors during sleep and are thought to be due to the sleep state instability. Some of them are benign, while some of them...
Parasomnias are abnormal and undesirable behaviors during sleep and are thought to be due to the sleep state instability. Some of them are benign, while some of them point to a possible underlying neurodegenerative process. This article briefly discusses the clinical characteristics, demographics, and pathophysiology of major parasomnias and associated disorders. The classification outlined in this article conforms to the current version of International Classification of Sleep disorders.
Topics: Humans; Parasomnias; Sleep
PubMed: 30228711
DOI: No ID Found -
MMW Fortschritte Der Medizin Sep 2007Parasomnias are characterized by undesired behaviour (e.g. sleep-walk, teeth-grinding) or unpleasant experiential phenomenon (e.g. nightmares) during sleep. They are...
Parasomnias are characterized by undesired behaviour (e.g. sleep-walk, teeth-grinding) or unpleasant experiential phenomenon (e.g. nightmares) during sleep. They are classified as arousal disorder, disturbances in the transitions between sleep states, REM-associated sleep disorders or as other parasomnias. In addition to general therapeutic measures to protect against self-inflicted and externally-inflicted injuries, different diagnostic and therapeutic options are available depending on the symptoms and the type of disorder present.
Topics: Diagnosis, Differential; Dreams; Epilepsy; Humans; Neurodegenerative Diseases; Parasomnias; Polysomnography; REM Sleep Parasomnias
PubMed: 17987744
DOI: 10.1007/BF03370872 -
Sleep Medicine Reviews Dec 2021Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia with dream-enactment behaviors occurring during REM sleep and associated with the lack of the... (Review)
Review
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia with dream-enactment behaviors occurring during REM sleep and associated with the lack of the physiological REM sleep muscle atonia. It can be isolated and secondary to other neurological or medical conditions. Isolated RBD heralds in most cases a neurodegenerative condition due to an underlying synucleinopathy and consequently its recognition is crucial for prognostic implications. REM sleep without atonia on polysomnography is a mandatory diagnostic criterion. Different conditions may mimic RBD, the most frequent being obstructive sleep apnea during sleep, non-REM parasomnia, and sleep-related hypermotor epilepsy. These diseases might also be comorbid with RBD, challenging the evaluation of disease severity, the treatment choices and the response to treatment evaluation. Video-PSG is the gold standard for a correct diagnosis and will distinguish between different or comorbid sleep disorders. Careful history taking together with actigraphy may give important clues for the differential diagnosis. The extreme boundaries of RBD might also be seen in more severe and complex conditions like status dissociatus or in the sleep disorders' scenario of anti IgLON5 disease, but in the latter both clinical and neurophysiological features will differ. A step-by-step approach is suggested to guide the differential diagnosis.
Topics: Humans; Parasomnias; Polysomnography; REM Sleep Behavior Disorder; Sleep Apnea, Obstructive; Sleep, REM
PubMed: 34186416
DOI: 10.1016/j.smrv.2021.101515