Table I compares the main diagnostic features of the three chosen types of parasomnia. The meaning of the three categories is as follows. The term “arousal disorders” refers to childhood confusional arousals, sleepwalking (calm and agitated forms of which are described) and sleep terrors. Used properly, nightmare is a straightforward term. As sleep-related epilepsy covers a number of seizure disorders of different types, permissible generalizations

are limited. The following types of epilepsy are, Inhibitors,research,lifescience,medical to varying degrees, related to sleep. The first four types have been classified as benign in the sense that, despite their focal origin in the brain, they are not typically the result of a structural abnormality and can be generally expected to remit spontaneously in time.25 All five types can readily be confused with nonepileptic Inhibitors,research,lifescience,medical parasomnias as their clinical features can be complex and dramatic. Benign partial epilepsy with centro -temp oral spikes (Rolandic epilepsy) is a common form of childhood epilepsy in which about 75% of patients have their seizures exclusively during sleep. The seizures involve

distressing oropharyngeal-facial movements and sensations Inhibitors,research,lifescience,medical corresponding to the anatomical origin of the seizures. Actually, some doubt has been raised recently about their entirely benign nature.26 Apparent terror and screaming occur in benign epilepsy with affective symptoms 27 The child’s reactions to the complex visual experiences (including hallucinations) that Inhibitors,research,lifescience,medical can occur in benign occipital epilepsy can involve dramatic find protocol behavior. In the Panayiotopoulos syndrome seizures often involve distressing vomiting and other autonomic symptoms. Nocturnal frontal lobe epilepsy (NFLE) deserves special mention because its clinical manifestations make it particularly prone to misinterpretation as nonepileptic phenomena. Although mainly

described in adults, it also occurs in Inhibitors,research,lifescience,medical children.28 It is now known that NFLE can take a variety of forms,29 but a usual variety is often misdiagnosed mainly because the complicated motor manifestations (eg kicking, hitting, rocking, thrashing, and cycling or scissor movements of the legs) and vocalizations (from grunting, coughing, muttering or moaning to shouting, screaming, or roaring) which characterize many attacks. As such, they are very different from other seizure types. The abrupt onset and termination, short cMet inhibitor duration of the attacks (different from seizures of temporal lobe origin) and, sometimes, preservation of consciousness can also suggest a nonepileptic (even attention-seeking) basis for the attacks. In the first instance, diagnosis rests on awareness of this form of epilepsy and recognition of its clinical features. EEG recordings, even during the episodes, are of limited diagnostic value. The distinction between epilepsy and other parasomnias can be difficult.