Content area
Full Text
Sleep Breath (2013) 17:465467 DOI 10.1007/s11325-012-0730-2
CASE REPORT
Electroencephalographic hypersynchrony in a child with night terrors
Scott G. Williams & Daniel Correa & Suzanne Lesage &
Christopher Lettieri
Received: 6 March 2012 /Revised: 3 May 2012 /Accepted: 29 May 2012 /Published online: 7 July 2012 # Springer-Verlag (outside the USA) 2012
Introduction
Hypersynchronous activity (whether hypnagogic or when associated with an arousal) is a common feature in childhood sleep [1]. Monorhythmic and paroxysmal hypnagogic hypersynchrony is most often seen from 3 months to 12 years of age at sleep onset, typically in stage 1. It is characterized by bursts of bisynchronous 75350 V 34.5 Hz waves often maximal in the fronto-central channels [2]. Paroxysms of hypersynchronous theta (47 Hz) and delta (0.52 Hz) waves have also been described as an arousal pattern out of non-rapid eye movement (NREM) sleep in children [3]. If these paroxysms are not accompanied by an increase in EMG tone or a return of the posterior dominant rhythm of wakefulness, it may be difficult to differentiate from an epileptiform discharge. In one case
series, rhythmic theta and delta activity was not a distinguishing feature between nocturnal frontal lobe epilepsy (NFLE) and parasomnias [4]. As such, it can be difficult to rule out epilepsy without a comprehensive clinical and electroencephalographic evaluation. We report a case of a child without epilepsy who demonstrated hypersynchronous EEG activity which preceded complex motor movements out of stage 3 sleep.
Report of case
A 7-year-old male with a history of spontaneously remitting night terrors at 4 years of age presented for evaluation of a recurrence of his symptoms. Four weeks prior to presentation, he started to wake up at night screaming most evenings approximately 3045 min after sleep onset, almost always preceded by arm movements as he was sleeping, without subsequent memory of the events. The episodes have varied and have included somnambulism and somniloquy. Specifically, it was noted by his parents that he was observed to walk down stairs, roll out of bed,...