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Case 28 - Seizure, parasomnia or behavioral disorder?

from Part V - Sleep-related epilepsy

Published online by Cambridge University Press:  10 November 2010

Antonio Culebras
Affiliation:
Upstate Medical University, New York
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Summary

This chapter discusses the case of a 10-year-old girl, who lived with her paternal grandmother as her divorced parents had recently failed an attempt at reconciliation, presented to a pediatric neurology clinic with a 3-week history of nocturnal and diurnal spells. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. The neurological examination revealed a patchy decrease to light touch in the left arm. The combination of the observed behavior and electroencephalography (EEG) findings suggested nocturnal frontal lobe epilepsy (NFLE), whereas the daytime events were considered to be panic attacks. The patient was treated with carbamazepine for NFLE and entered formal counseling with behavior modification techniques for daytime panic attacks. The clear differentiation between NFLE, parasomnias and behavioral disorders is often difficult, as in any given patient the neurological examination, EEG and brain imaging studies can all be normal.
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Information
Case Studies in Sleep Neurology
Common and Uncommon Presentations
, pp. 193 - 199
Publisher: Cambridge University Press
Print publication year: 2010

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