Pavor nocturnus of proven epileptic origin

Purpose: To evaluate the suspected epileptic origin in children with episod es masquerading as sleep terrors. Method: One such child was investigated with scalp-derived long-term monito ring (LTM), inter and ictal single photon emission computed tomography (SPE CT) scans, and an invasive LTM, followed by surgical subpial slicing of the focally motor cortex. Results: The scalp-derived LTM and the SPECT scans did not localize the sus pected epileptogenic focus. The invasive discharging LTM revealed the focal onset of the ictal discharge. After the surgery, the seizures have been 90 % controlled. No deficits resulted from the surgery. Conclusions: Although most nocturnal terrors (NTs) are parasomnias, in a fe w children their frequent episodes that masquerade as NTs have an epileptic origin. There are several features to distinguish these from common NTs or from other frontal lobe epilepsies.