Feature | Parasomnias* | Nocturnal seizures |
Age of onset | Preschool-age and childhood | Infancy, preschool-age, childhood, and adolescence |
Family history of similar events | May be positive | May or may not be positive |
Time of occurrence | First one-third of night sleep (usually) | Randomly through the night |
Most common sleep stage at occurrence | Stage N3 sleep¶ | Stage N1 or N2 sleep |
Duration of event | 5 to 30 minutes | 0.5 to 5 minutes |
Multiple events on a single night | Less likely | More likely |
Polysomnogram (with EEG) | Rhythmic theta or delta activity during the event; movement artifact may be present | Normal, or spikes or sharp waves over a focal or generalized distribution During the event, an ictal (seizure) pattern may be present on scalp EEG Movement artifact may be present |
Usual daytime behavior | Normal (unless complicated by sleep-related breathing disturbance or restless legs/periodic limb movement disorder) | May be irritable and sleepy; seizures may also occur during the day |
Pharmacologic therapy | Benzodiazepine at bedtime | Daytime and bedtime administration of oxcarbazepine, lamotrigine, levetiracetam, carbamazepine, or phenytoin |
EEG: electroencephalogram; NREM: non-rapid eye movement.
* The most common parasomnias in children are sleepwalking, confusional arousals, and sleep terrors, which occur upon partial arousal from NREM sleep.
¶ NREM sleep is divided into stages N1, N2, and N3. Stage N3 was previously known as "slow-wave sleep."Do you want to add Medilib to your home screen?