Electroclinical findings of minor motor events during sleep in temporal lobe epilepsy

Abstract

The results of our study demonstrated the presence of minor motor events during sleep in patients with MTLE, suggesting an epileptic origin of these episodes. The study of nocturnal sleep in MTLE patients is useful in helping the clinicians in the diagnostic and therapeutic workup of these patients.

Seizures with paroxysmal arousals in sleep‐related hypermotor epilepsy (SHE): Dissecting epilepsy from NREM parasomnias

“…The movements were classified into three groups: (a) physiological movements—body position changes, adjusting position, scratching, stretching, and fixing dresses or blankets; (b) movements codified in the ICSD‐3—limb movements (LMs), periodic limb movements (PLMs), alternating leg muscle activation (ALMA), hypnic jerks, rhythmic masticatory muscle activity (RMMA), hypnagogic foot tremor, and rhythmic movements 12 ; and (c) movements not codified in the ICSD‐3 but well‐described in literature studies—neck myoclonus, oro‐alimentary automatisms 16,17 …”

“…The movements were classified into three groups: (a) physiological movements-body position changes, adjusting position, scratching, stretching, and fixing dresses or blankets; (b) movements codified in the ICSD-3-limb movements (LMs), periodic limb movements (PLMs), alternating leg muscle activation (ALMA), hypnic jerks, rhythmic masticatory muscle activity (RMMA), hypnagogic foot tremor, and rhythmic movements 12 ; and (c) movements not codified in the ICSD-3 but well-described in literature studies-neck myoclonus, oro-alimentary automatisms. 16,17 For each SHE patient, SPAs (Video S2) were recognized as stereotypic seizures, lasting <20 seconds, resembling the motor pattern observed at the beginning of a recorded major seizure (Video S1) according to the description of Provini et al 3 For each DOA patient, SAMs episodes lasting <20 seconds were recognized according to Loddo et al classification: head flexion/extension movements (pattern IA) (Video S5); head flexion extension and limb movement (pattern IB); and head flexion/extension and partial trunk flexion/extension movements (pattern IC). 13 For each SPAs and SAMs, the following was identified: sleep stage at onset; duration (defined from onset to the end of any motor activity observed in the video recording); body spatial distribution at onset-focal (involving one body part), segmental (involving one or more contiguous body parts), multifocal (involvement of less than three noncontiguous body parts), generalized (involving three or more than three noncontiguous body parts); and progression of movements during the episode.…”

“…In healthy controls, no SPAs or SAMs were recorded. Only 11 movements in 6 subjects consisting of head and/or trunk flexion/extension movements showed some resemblance to SAMs (median duration 16 seconds; IQR: [15][16][17]. Unlike in SAMs, these movements were not isolated, but appeared in the context of a body position change (45%) or while adjusting position (55%), mostly during stage 1-2 NREM sleep (64%; Table 3).…”

Bilateral dependence of sleep disorders and temporal lobe epilepsy – literature review

“…Giuliano et al [50] noted in their study that little is known about minor motor events in people diagnosed with MTLE. Their aim, therefore, was to determine the frequency of occurrence of the afore-mentioned pathology in MTLE and to characterize this relationship.…”

“…In a study by Giuliano et al [50], 15 patients with MTLE were involved (8 men and 7 women) with an average age of 31.8 ± 14.9 years, and 15 healthy volunteers (6 men and 9 women) with an average age of 32.8 ± 11.2 years. Each participant underwent long-term video-EEG monitoring (LTM) measurements with at least 8 channels.…”