SUMMARY. Purpose: To test the usefulness of the FLEP scale in diagnosing nocturnal frontal lobe epilepsy (NFLE), arousal parasomnias, and. The Frontal Lobe Epilepsy and Parasomnias (FLEP) Scale. Clinical Feature. Score. Age at onset. At what age did the patient have their first clinical event? < 55y. Created by Derry and colleagues , the item FLEP scale is designed to aid clinicians in distinguishing frontal lobe seizures from parasomnias.
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Table 2 from Epilepsy and sleep. – Semantic Scholar
Neurology ;42 7 Suppl. Mean duration of the seizure history was 9. No case had a spontaneous remission. Nocturnal temporal lobe epilepsy.
Nocturnal epilepsy in adults.
Sign in to make a comment Sign in to your personal account. The second scalw, a year-old woman with a positive family history of parasomnia, had almost exclusively nocturnal high-frequency seizures with rolling movements of the pelvis followed by hypertonic-hyperkinetic activity and sleeptalking with bruxism.
Epileptic seizures are often strongly influenced by the sleep-wake cycle. The diagnosis of abnormal paroxysmal motor events in sleep presents a particular challenge for the clinician. We therefore only had video-EEG or PSG data on those patients with atypical parasomnias, in whom the diagnosis was regarded as uncertain. Meaning of the study and use of the scale.
The latter group of seven patients with temporal lobe origin had anamnestic and clinical features that mirrored the clinical features found in the 18 patients with frontal onset, with agitated movements, high seizure frequency and absent history of febrile convulsions.
All eight cases had normal wake scalp EEG activity. Schlaf und Epilepsie PD Dr. Twenty-two subjects were not contactable or declined to participate in the study, leaving a total of 31 participants 15 men with NFLE, 11 8 men with atypical parasomnias, and 20 12 men with typical parasomnias. Therefore, all the clinical features in this case series of 24 Caucasian patients from Italy closely match the findings in our case series of eight Taiwanese patients.
New approach for analyzing self-reporting of insomnia symptoms reveals a high rate of comorbid insomnia across a wide spectrum of chronic diseases. Get free access to newly published articles Create a personal account or sign in to: DuncanSamuel F. Nocturnal frontal lobe epilepsy sporadic, familialNocturnal paroxysmal dystonia, Paroxysmal arousals, Nocturnal temporal lobe epilepsy, Video-polysomnography, Anticonvulsant therapy.
Critical revision of the manuscript for important intellectual content: Administrative, technical, and material support: To our knowledge, this is the first study to systematically assess the reliability of salient historical features in the diagnosis of paroxysmal events in sleep.
Due to safety considerations , oxcarbamazepine was also the initial treatment of choice. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more.
For interviewer 2 medically trainedsensitivity was 1. This monitoring provided important and relatively rare on account of the intracerebral monitoring insights into the clinical and neurophysiological manifestations of the episodes. While both individuals conducting the interviews had some experience in taking epilepsy histories, the fact that the scores of the physician and the research assistant who is not medically trained were very similar suggests that specialist epileptological or sleep training is not required to reliably use this scale.
For interviewer 1 nonmedically trainedsensitivity was 1. PAs featured head elevation sxale with open eyes followed by truncal elevation, with the patient sitting up and looking around for a few seconds. They also received a full neurological examination by a pediatric or adult neurologist.
The differential diagnosis, particularly focused on nocturnal temporal lobe epilepsy [7,8] and the parasomnias, will be discussed.
Stereo-EEG showed that all PAs were correlated to a discharge of polyspikes localized over the dorsolateral cortex of the sdale frontal gyrus. The absence of scalp EEG ictal epileptic activity during the NFLE seizure attacks in some patients can be explained by the seizure focus being located in deep brain regions, as previously discussed . Sign in to save your search Sign in to your personal acale. Comparison with other studies. Sleep apnoea and the neurologist.
In these three cases, however, daytime seizures were sporadic with low frequency. While a number of authors have described clinical features that are suggestive of NFLE, the majority have emphasized the need for confirmatory PSG.
Likewise, prompt investigation and treatment will be possible in those individuals with epilepsy.
In a retrospective study of consecutive patients with drug-resistant hyperkinetic seizures that were surgically treated, 25 of these patients had sleep-related hyperkinetic seizures, of which 18 had a frontal lobe onset, and 7 had a temporal lobe onset .
Create a free personal account to download free article PDFs, sign up for alerts, and more. In one patient patient 8the interictal EEG was characterized by spike-and-waves activity Fig.