TY - JOUR
T1 - Sleep-related minor motor events in nocturnal frontal lobe epilepsy
AU - Terzaghi, Michele
AU - Sartori, Ivana
AU - Mai, Roberto
AU - Tassi, Laura
AU - Francione, Stefano
AU - Cardinale, Francesco
AU - Castana, Laura
AU - Cossu, Massimo
AU - LoRusso, Giorgio
AU - Manni, Raffaele
AU - Nobili, Lino
PY - 2007/2
Y1 - 2007/2
N2 - Purpose: Nocturnal frontal lobe epilepsy (NFLE) is characterized by a wide spectrum of sleep-related motor manifestations of increasing complexity, ranging from major episodes to brief motor events (minor motor events, MMEs). NFLE patients may exhibit a large quantity of MMEs in the form of short-lasting stereotyped movements. Whereas major episodes are considered epileptiform manifestations, it remains unclear whether the MMEs are related to epileptiform discharges (EDs). Methods: To study the relation between EDs and the occurrence of MMEs, we report a detailed neurophysiolgical evaluation in NFLE subjects explored by using implanted electrodes. Results: The median value of ED-related movements was 71.8%. Motor expression in relation to epileptiform discharge was surprisingly variable; no peculiar expression of MMEs could be attributed to the presence of EDs. Conclusions: Our data suggest that ED-associated MMEs are extremely polymorphous, and no univocal relation to EDs can be identified. We hypothesize that MMEs are not a direct effect of epileptiform discharge (i.e., not epileptic in origin), but the result of aspecific disinhibition of innate motor patterns. We warn clinicians that the epileptic nature of minimal motor phenomena in NFLE cannot be established on the clinical phenomenology of the event.
AB - Purpose: Nocturnal frontal lobe epilepsy (NFLE) is characterized by a wide spectrum of sleep-related motor manifestations of increasing complexity, ranging from major episodes to brief motor events (minor motor events, MMEs). NFLE patients may exhibit a large quantity of MMEs in the form of short-lasting stereotyped movements. Whereas major episodes are considered epileptiform manifestations, it remains unclear whether the MMEs are related to epileptiform discharges (EDs). Methods: To study the relation between EDs and the occurrence of MMEs, we report a detailed neurophysiolgical evaluation in NFLE subjects explored by using implanted electrodes. Results: The median value of ED-related movements was 71.8%. Motor expression in relation to epileptiform discharge was surprisingly variable; no peculiar expression of MMEs could be attributed to the presence of EDs. Conclusions: Our data suggest that ED-associated MMEs are extremely polymorphous, and no univocal relation to EDs can be identified. We hypothesize that MMEs are not a direct effect of epileptiform discharge (i.e., not epileptic in origin), but the result of aspecific disinhibition of innate motor patterns. We warn clinicians that the epileptic nature of minimal motor phenomena in NFLE cannot be established on the clinical phenomenology of the event.
KW - Arousal
KW - Central pattern generators
KW - Innate behaviors
KW - Minimal motor events
KW - Nocturnal frontal lobe epilepsy
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U2 - 10.1111/j.1528-1167.2006.00929.x
DO - 10.1111/j.1528-1167.2006.00929.x
M3 - Article
C2 - 17295628
AN - SCOPUS:33846817075
VL - 48
SP - 335
EP - 341
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - 2
ER -