Nuits mouvementées et bruyantes : comment différencier parasomnies et crises d'épilepsie frontale nocturnes ? Intérêt de l'enregistrement vidéo-EEG-polysomnographique

The causes of nocturnal paroxysmal phenomena are numerous including psychiatric disturbances (nocturnal panic attacks for example), epileptic seizures and sleep disorders. Most often, clinical history, context, the description by relatives and the occurrence of daytime episodes allow a diagnostic orientation. Nevertheless, sometimes, the clinical history is atypical and it is difficult to distinguish nocturnal seizure from nonepileptic motor phenomena arising from sleep. This is the case for nocturnal frontal lobe epilepsy seizures, which appear only during sleep. This kind of seizure is characterized by short motor pattern and sometimes violent behaviour, as it is possible to see in some NREM arousal parasomnias or REM behaviour disorders. In this case, the clinician can use the scale Frontal lobe Epilepsy and Parasomnias (FLEP), not yet validated, but nocturnal video-EEG-polysomnography is usually required to make difference.