Episode during
NREM
Continuous Spikes and
Waves during Slow-Wave
Sleep (CSWS)
Disorder of arousal
(Confusion arousal,
Night terror,
Somnambulism)
Nocturnal Frontal Lobe
Epilepsy (NFLE)
Ictal scalp EEG Continuous spike-wave
discharges: if SWI >85% of
NREM is called Electrical
Status Epilepticus in Sleep
(ESES).
It is sleeping disorder not
seizure:
Normal EEG but increase
autonomic -EKG,
respiratory rate
Most are normal or
rarely frontal SWs which
obscured with muscle
artifacts
Clinical corelate Subtle (Electrographic
seizure)
Impair cognitive esp.
declarative memory
Landau-Kleffner
Syndrome (LKS) is
language deficit subtype
Confusion arousal:
minimal, cause confusion
during episode and day-
time sleepiness
Night terror: fear
Somnambulism: complex
motor ie walking, eating
Mimic presentation of
arousal disorder but last
shorter than few
minutes.
Day-time sleepiness
from disrupted sleep.
Family History + ++ +++ (AD)
Prognosis ESES peak at age 4-8 and
remit at age 8-12 : seizure
subside along with ESES but
cognitive impair remained
Peak in childhood 4-12 and
most are resolved when
growing up
Onset any age up to 20s
life-long but not
progress.
Rx -Carbamazepine:
target Ach receptor
mutation.
