Rhythmic movements in sleep disorders and in epileptic seizures during sleep

Abstract

Rhythmic movements during sleep may occur in the context of physiological sleep-related motor activity or be part of sleep-related movement disorders such as bruxism, periodic limb movement disorder, restless legs syndrome, and sleep-related rhythmic movement disorder. They may also characterize some frontal or temporal nocturnal seizures of sleep-related hypermotor epilepsy, or be considered as part of NREM parasomnias, especially sleepwalking, sexsomnia or sleep-related eating disorder, or REM-related behaviors such as REM behavior disorder or complex movements associated with pediatric narcolepsy type I. In most cases rhythmic movements, especially when complex and long in duration, are related to different levels of arousal from sleep with recurrence of ancestral motor sequences promoted by central pattern generators in the brainstem, generally activated by the arousal process. A differential diagnosis between physiological events and pathological movement disorders, and between the latter and sleep-related epilepsy is critical to provide optimal treatment and an accurate prognosis. Specific treatment options for the aforementioned disorders are beyond the scope of this article.

Hypothermic Protection in Neocortex Is Topographic and Laminar, Seizure Unmitigating, and Partially Rescues Neurons Depleted of RNA Splicing Protein Rbfox3/NeuN in Neonatal Hypoxic-Ischemic Male Piglets

“…This pathway, alone or in combination with damage to the cerebellum, another potent inhibitory modulator of Deiter's neurons [122,123], could be inactivated in HI piglets with neocortical damage. "Released" central pattern generators in the brainstem [126,127] could also be involved in the fictive locomotor activity we observed and documented by video recording in some piglets with seizures (see Supplementary Material Videos S1-S3).…”

Commonalities and Differences in NREM Parasomnias and Sleep-Related Epilepsy: Is There a Continuum Between the Two Conditions?

“…In SHE patients, the majority of NREM seizures arose from stage N2, but most major attacks showed a preferential occurrence during SWS (57%). The different distribution of motor episodes across the night and within the NREM stages is a widely accepted issue (6,35,48). According to a recent study, the occurrence of at least one minor event during stage N3 is highly suggestive for DoA, while the occurrence of at least one major event outside stage N3 is highly suggestive for SHE (47).…”

Ictal kissing: Review of literature and report of 5 cases

“…The younger the brain, due to incomplete myelination, the more vulnerable the motor control, quickly escaping the neopallium guidance; this is one of the reasons disorders of arousal in children and adolescents are defined as genetically determined patterns of immature brains 16 . One of our patients was 16 years old, and the other four were in their third decade.…”