Abstract
There is a wide range of different paroxysmal motor events with various aetiology during sleep. The most important issue in their evaluation is to distinguish epileptic seizures from other sleep disorders.
Sleep-related epileptic seizures are relatively frequent and they may occur predominantly or exclusively during sleep in approximately 12 %. The most frequent seizure type during sleep is a focal hyperkinetic seizure in the frame of the sleep-related hypermotor epilepsy (SHE), previously known as nocturnal frontal lobe epilepsy, which is a heterogeneous group in terms of aetiology and localization of epileptic focus.
The differentiation of SHE from NREM parasomnia may sometimes be difficult, because of relatively frequent cooccurrence of both disorders and because of some shared pathophysiological mechanisms. Other possibilities of paroxysmal motor events during sleep represent REM sleep behaviour disorder, sleep-related movement disorders including sleep-related rhythmic movement disorder, sleep startle, periodic leg movement and various forms of myoclonus.
Last but not least the psychogenic non-epileptic seizures or panic attacks may occur during the night.