Nocturnal Temporal Lobe Epilepsy

Abstract Background: Epilepsy and sleep have been reported to be closely associated. However, the mechanisms involved in this association remains unclear. Epileptic seizures during sleep may be misdiagnosed as parasomnias or movement disorders and can be associated with daytime sleepiness and poor quality of life. Nocturnal temporal lobe epilepsy (NTLE) has recently been recognized and is considered rare. Herein, we intend to present a case of a patient with NTLE with epileptic seizures occurring exclusively during sleep—initially diagnosed and treated as a sleep disturbance disorder. Case Presentation: A 24-year-old female reported to have been treated for disturbed sleep. A 24-hour video-electroencephalogram (V-EEG) was then performed, which showed acute waves, spikes, and complex spike-slow waves of great amplitude, isolated, and in outbreaks in the left temporal region, with abrupt choreoathetotic, generalized, and asymmetric body movements. Conclusion: The importance of this case lies in the presentation of exclusively nocturnal epileptic seizures, without personal or family history of epilepsy, with normal imaging findings along with V-EEG evidence of epileptic discharges in the left temporal lobe. Therefore, diagnosing NTLE is challenging and must be considered in patients presenting with paroxysmal motor sleep events. Additionally, detailed description of the seizures and V-EEG are fundamental factors that could aid in confirming the diagnosis.