{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:55:53Z","timestamp":1792194953011,"version":"4.4.0"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T00:00:00Z","timestamp":1600473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Sleep\u2010related hypermotor epilepsy (SHE) is a focal epilepsy characterized by seizures occurring mostly during sleep, ranging from brief seizures with paroxysmal arousals (SPAs) to hyperkinetic seizures and ambulatory behaviors. SPAs are brief and stereotypic seizures representing the beginning of a major seizure. Distinguishing SPAs from disorders of arousal (DOAs) and their briefest episodes called simple arousal movements (SAMs) is difficult. We performed a characterization of SPAs and SAMs to identify video\u2010polysomnographic (VPSG) features that can contribute to the diagnosis of SHE or DOA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifteen SHE, 30 DOA adult patients, and 15 healthy subjects underwent full\u2010night VPSG. Two neurologist experts in sleep disorders and epilepsy classified all the sleep\u2010related movements and episodes recorded. For each SPAs and SAMs, sleep stage at onset, duration, limb involvement, progression, and semiology have been identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 121 SPAs were recorded, emerging mostly during stage 1\u20102 non\u2013rapid eye movement (NREM) sleep (median duration: 5\u00a0seconds). At the beginning, the SPAs motor pattern was hyperkinetic in 78 cases (64%), involving more than three non\u2010contiguous or all body parts. The standard was a constant progression of movements during SPAs without any motor arrests. In DOA patients a total of 140 SAMs were recorded (median duration: 12\u00a0seconds) mostly emerging during stage 3 NREM sleep. In SAMs, we did not observe any tonic\/dystonic or hypermotor patterns or stereotypy; motor arrest was present over the course of about half of the episodes. In comparison with both DOA and healthy subjects, SHE patients showed a higher number of sleep\u2010related movements per night and a reduction of sleep efficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>SPAs and SAMs present different semiological and clinical features. Their recognition could be useful to drive the diagnosis when major episodes are not recorded during VPSG in patients with a clear clinical history of SHE or DOA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16659","type":"journal-article","created":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T18:22:15Z","timestamp":1600539735000},"page":"2194-2202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Seizures with paroxysmal arousals in sleep\u2010related hypermotor epilepsy (SHE): Dissecting epilepsy from NREM parasomnias"],"prefix":"10.1111","volume":"61","author":[{"given":"Giuseppe","family":"Loddo","sequence":"first","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Baldassarri","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Zenesini","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-9895","authenticated-orcid":false,"given":"Laura","family":"Licchetta","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1109-7296","authenticated-orcid":false,"given":"Francesca","family":"Bisulli","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Cirignotta","sequence":"additional","affiliation":[{"name":"Department of Head, Neck and Sensory System Neurology Unit Sant' Orsola\u2010Malpighi Hospital University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Mondini","sequence":"additional","affiliation":[{"name":"Department of Head, Neck and Sensory System Neurology Unit Sant' Orsola\u2010Malpighi Hospital University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Tinuper","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9063-2658","authenticated-orcid":false,"given":"Federica","family":"Provini","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna 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