Some epilepsy syndromes feature activity exclusively or predominantly during sleep and can be confused with other nocturnal events, such as parasomnias. These syndromes include:

• Autosomal-dominant nocturnal frontal lobe epilepsy
• Supplementary sensorimotor seizures
• Nocturnal paroxysmal dystonia
• Benign epilepsy of childhood with centrotemporal spikes
• Lennox-Gastaut syndrome (tonic seizures)
• Nocturnal temporal lobe epilepsy
• Juvenile myoclonic epilepsy
• Generalized tonic-clonic seizures on awakening
• Continuous spike waves during slow-wave sleep

The following pages describe some of the features distinguishing common parasomnias from nocturnal seizures and psychogenic events. Features that can be used in the differential diagnosis of nocturnal events include the time of occurrence, whether the patient remembers the event, stereotypical movements, and polysomnogram findings, as summarized in Table: Differential Diagnosis of Nocturnal Events.

Adapted from: Malow, BA, and Vaughn BV. Sleep disorders and epilepsy. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;255–267.
With permission from Elsevier (www.elsevier.com).
Reviewed and revised April 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.