Hyperkinetic manifestations in nocturnal frontal lobe epilepsy. Semeiological features and physiopathological hypothesis.

Nocturnal frontal lobe epilepsy is a syndromic entity that includes paroxysmal episodes with variable semeiology, intensity and duration, representing different aspects of the same epileptic condition. In a large series studied by videopolysomnographic recording at the Department of Neurological Sciences in Bologna, we disclosed four main semeiological patterns: the paroxysmal arousals, brief simple motor phenomena, similar to a sudden arousal, recurring several times per night; the hypermotor seizures, more complex motor episodes with violent motor behaviour, vocalisation, screaming, fearful and repetitive movements of the trunk and limbs; asymmetric, bilateral tonic seizures, which can evoke the seizures from the frontal mesial area; and epileptic nocturnal wanderings, which can mimic sleepwalking episodes.