{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:25:53Z","timestamp":1791959153380,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T00:00:00Z","timestamp":1552435200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RF-2010-2319316"],"award-info":[{"award-number":["RF-2010-2319316"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2019,4]]},"abstract":"Summary<\/jats:title>\n \n Objectives<\/jats:title>\n \n Sleep\u2010related hypermotor epilepsy (\n SHE<\/jats:styled-content>\n ), formerly nocturnal frontal lobe epilepsy, is characterized by abrupt and typically sleep\u2010related seizures with motor patterns of variable complexity and duration. They seizures arise more frequently in the frontal lobe than in the extrafrontal regions but identifying the seizure onset\u2010zone (\n SOZ<\/jats:styled-content>\n ) may be challenging. In this study, we aimed to describe the clinical features of both frontal and extrafrontal\n SHE<\/jats:styled-content>\n , focusing on ictal semiologic patterns in order to increase diagnostic accuracy.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively analyzed the clinical features of patients with drug\u2010resistant\n SHE<\/jats:styled-content>\n seen in our center for epilepsy surgery. Patients were divided into frontal and extrafrontal\n SHE<\/jats:styled-content>\n (temporal, operculoinsular, and posterior\n SHE<\/jats:styled-content>\n ). We classified seizure semiology according to four semiology patterns (\n SP<\/jats:styled-content>\n s): elementary motor signs (\n SP<\/jats:styled-content>\n 1), unnatural hypermotor movements (\n SP<\/jats:styled-content>\n 2), integrated hypermotor movements (\n SP<\/jats:styled-content>\n 3), and gestural behaviors with high emotional content (\n SP<\/jats:styled-content>\n 4). Early nonmotor manifestations were also assessed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Our case series consisted of 91 frontal\n SHE<\/jats:styled-content>\n and 44 extrafrontal\n SHE cases<\/jats:styled-content>\n . Frontal and extrafrontal\n SHE<\/jats:styled-content>\n shared many features such as young age at onset, high seizure\u2010frequency rate, high rate of scalp\n electroencephalography (EEG<\/jats:styled-content>\n ) and magnetic resonance imaging (\n MRI)<\/jats:styled-content>\n abnormalities, similar histopathologic substrates, and good postsurgical outcome. Within the frontal lobe,\n SP<\/jats:styled-content>\n s were organized in a posteroanterior gradient (\n SP<\/jats:styled-content>\n 1\u20104) with respect to the\n SOZ<\/jats:styled-content>\n . In temporal\n SHE<\/jats:styled-content>\n ,\n SP<\/jats:styled-content>\n 1 was rare and\n SP<\/jats:styled-content>\n 3\u20104 frequent, whereas in operculoinsular and posterior\n SHE<\/jats:styled-content>\n ,\n SP<\/jats:styled-content>\n 4 was absent. Nonmotor manifestations were frequent (70%) and some could provide valuable localizing information.\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n \n Our study shows that the presence of certain\n SP<\/jats:styled-content>\n and nonmotor manifestations may provide helpful information to localize seizure onset in patients with\n SHE<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/epi.14690","type":"journal-article","created":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T18:15:23Z","timestamp":1552500923000},"page":"707-717","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Clinical features of sleep\u2010related hypermotor epilepsy in relation to the seizure\u2010onset zone: A review of 135 surgically treated cases"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8489-4907","authenticated-orcid":false,"given":"Steve A.","family":"Gibbs","sequence":"first","affiliation":[{"name":"Department of Neurosciences Center for Epilepsy Surgery \u201cC. Munari,\u201d Hospital Niguarda Milan Italy"},{"name":"Department of Neurosciences Center for Advanced Research in Sleep Medicine H\u00f4pital du Sacr\u00e9\u2010C\u0153ur de Montr\u00e9al University of Montreal Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Proserpio","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Center for Epilepsy Surgery \u201cC. Munari,\u201d Hospital Niguarda Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Francione","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Center for Epilepsy Surgery \u201cC. Munari,\u201d Hospital Niguarda Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Mai","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Center for Epilepsy Surgery \u201cC. Munari,\u201d Hospital Niguarda Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5141-9202","authenticated-orcid":false,"given":"Francesco","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Center for Epilepsy Surgery \u201cC. Munari,\u201d Hospital Niguarda Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Sartori","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Center for Epilepsy Surgery \u201cC. Munari,\u201d Hospital Niguarda Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Castana","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Center for Epilepsy Surgery \u201cC. Munari,\u201d Hospital Niguarda Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Plazzi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Tinuper","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1891-7648","authenticated-orcid":false,"given":"Massimo","family":"Cossu","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Center for Epilepsy Surgery \u201cC. 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