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 [1], the item FLEP scale is designed to aid clinicians in distinguishing frontal lobe seizures from parasomnias.

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The nocturnal paroxysmal episodes had been present for up to 18 yrs mean 9.

Table 4 from Nocturnal epilepsy in adults. – Semantic Scholar

No case had a spontaneous remission. The sensitivity of 1 and specificity of 0. Meaning of the study and use of the scale.

Video-PSG documented a wide spectrum of NFLE behaviors, ranging from repeated stereotypic brief motor attacks to prolonged attacks with complex and bizarre behaviors. Diagnostic and Coding Manual. The differential diagnosis, particularly focused on nocturnal temporal lobe epilepsy [7,8] and the parasomnias, will be discussed. Intracerebral activity video-EEG was monitored concurrently with scalp EEG and documented many rolling pelvic movements related to arousal fluctuations during NREM sleep and lasting sec.

Analysis and interpretation of data: A further potential criticism relates to scwle absence of confirmatory video-EEG monitoring in the consecutive series of typical parasomnias. Create a personal account to register for email alerts with links to free full-text articles. WalkerJohn S. Of the 62 patients interviewed, 3 had their conditions incorrectly diagnosed using the scale; these were all patients with parasomnias who generated ecale positive scores. A missense mutation in the neuronal nicotinic acetylcholine receptor alpha 4 subunit is associated with autosomal dominant nocturnal frontal lobe epilepsy.


Husain and Saurabh R. From This Paper Figures, tables, and topics from this paper. Long-term home monitoring of hypermotor seizures by patient-worn accelerometers. Nocturnal frontal lobe epilepsy sporadic, familialNocturnal paroxysmal dystonia, Paroxysmal arousals, Nocturnal temporal lobe epilepsy, Video-polysomnography, Anticonvulsant therapy.

Epilepsy and sleep.

The aim of the study was to compare the diagnosis made using the FLEP scale with the standard diagnostic test ie, expert interview and, when necessary, zcale of events using video-EEG monitoring. Nocturnal epilepsy in adults. Distinguishing sleep disorders from seizures: Topiramate treatment for nocturnal frontal lobe epilepsy.

Purchase access Subscribe to JN Learning for one year. These eight patients completed a comprehensive questionnaire covering lifetime sleep-wake, medical and psychiatric history, and review of systems. Diagnosing Bumps in the Night.

Sleep Science – Sporadic nocturnal frontal lobe epilepsy: A consecutive series of 8 cases

If a secure diagnosis of parasomnias has been made by an expert on the basis of the history, it is rarely justified, clinically or economically, to flrp a child for prolonged monitoring, and the investigation may well be fruitless for episodic attacks. For interviewer 1 nonmedically trainedsensitivity was 1. Recent studies have provided new insights into the links between the disorders that may facilitate differential diagnosis and treatment but may also improve our understanding of underlying pathophysiological mechanisms.

DuncanSamuel F.

Nocturnal frontal lobe epilepsy sporadic, familialNocturnal paroxysmal dystonia, Paroxysmal arousals, Nocturnal temporal lobe epilepsy, Video-polysomnography, Anticonvulsant therapy 1. Thus, these three cases sccale the frontal epileptic origin of MMEs and supported prior postulations that the increasing complexity of ictal motor behavior could reflect a different length and spread of the discharge within the frontal lobe [6].


The electrooculogram channels 7—8 indicates no rapid eye movements. During the interviews, clinical information was obtained from the patient and a witness usually the patient’s partner, relative, or parent in the case of a child. Curr Treat Options Neurol ; In nocturnal frontal lobe epilepsy NFLEthe unusual seizure features often lead to diagnostic confusion with nonepileptic parasomnias; video-electroencephalography monitoring is usually required to make the diagnosis.

This scenario poses a major challenge for sleep clinicians. Topics Discussed in This Paper. Parasomnias and other nocturnal events. Get free access to newly published articles Create a personal account or sign in to: Some types of sleep-related epilepsy present with bizarre behaviors or vocalization, but without convulsion-like movement, tongue biting or upward gaze. EEG montage channels 12—19 shows a run of spike-and-waves during an interictal period. Hypnogenic paroxysmal dystonia; epileptic seizures or a new syndrome?

Repetitive and stereotypical behaviors characterize the clinical presentation without change in scalp EEG; the aura and the postictal periods can be masked by sleep.

Lino Nobili Sleep medicine reviews At times, she had an aura with the sensation “as if the body moved around its axis. Cases used in the pilot study were not recruited into the formal validation study.

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