Stimulus-Induced, Sleep-Bound, Focal Seizures: A Case Report
Francesca Siclari, MD1,3; Lino Nobili, MD, PhD6; Giorgio Lo Russo, MD6; Alessio Moscato, Phy MSc6; Alfred Buck, MD2; Claudio L. Bassetti, MD1,4; Ramin Khatami, MD1,5
1Department of Neurology, University Hospital Zürich, Switzerland; 2Nuclear medicine, University Hospital Zürich, Switzerland; 3University Hospital Lausanne, Switzerland; 4Neurocenter of Southern Switzerland, Lugano, Switzerland; 5Barmelweid Sleep Clinic, Barmelweid, Switzerland; 6Epilepsy Surgery Center, Niguarda Hospital Milan, Italy
In nocturnal frontal lobe epilepsy (NFLE), seizures occur almost exclusively during NREM sleep. Why precisely these seizures are sleep-bound remains unknown. Studies of patients with nonlesional familial forms of NFLE have suggested the arousal system may play a major role in their pathogenesis. We report the case of a patient with pharmaco-resistant, probably cryptogenic form of non-familial NFLE and strictly sleep-bound seizures that could be elicited by alerting stimuli and were associated with ictal bilateral thalamic and right orbital-insular hyperperfusion on SPECT imaging.
University Hospital Zurich.
Patients or Participants:
One patient with pharmaco-resistant epilepsy.
This case shows that the arousal system plays a fundamental role also in cryptogenic non-familial forms of NFLE.
Siclari F; Nobili L; Lo Russo G; Moscato A; Buck A; Bassetti CL; Khatami R. Stimulus-induced, sleep-bound, focal seizures: a case report. SLEEP 2011;34(12):1727-1730.