THE NEUROPHYSIOLOGICAL EVALUATION OF NOCTURNAL FRONTAL-LOBE EPILEPSY

The most reliable technique for the diagnosis of nocturnal frontal lob e epilepsy (NFLE) is nocturnal video-polysomnography, which is an expe nsive procedure and unavailable in many Departments of Neurology and E pileptology around the world. The aim of the present study was to eval uate the role of routine video-EEG and video-EEG after sleep deprivati on, during the daytime, in the diagnosis of NFLE. We studied 23 patien ts complaining of repeated nocturnal motor attacks using a 3-level neu rophysiological evaluation, including video-EEG when awake (level 1), video-EEG after sleep deprivation, during the daytime (level 2) and no cturnal video-polysomnography (level 3). All the patients had a normal video-EEG when awake. The video-EEG after sleep deprivation (level 2) allowed a diagnosis of NFLE in 52.2% of the patients, while the noctu rnal video-polysomnography (level 3) allowed this diagnosis in 87.0% o f the same sample. In the patients complaining of repeated nocturnal m otor attacks, a video-EEG after sleep deprivation performed during the daytime, could be useful for diagnosis in about one half of cases. Th is methodology is routinely performed in many Departments of Neurology and Epileptology, and is much less binding acid expensive than noctur nal video-polysomnography and so it could be important economically fo r the health service.