Unexpected EEG Abnormalities in Adults with Parasomnia – A Case Series

Patients with complex nocturnal behaviors (parasomnia, sleepwalking) can sometimes be difficult to distinguish from those with epilepsy.The differential diagnosis includes identifying abnormalities on electroencephalography (EEG) that are specific for epilepsy epileptiform discharges. Although these are rarely seen in individuals without epilepsy, and unknown to be associated with sleep disorders, we unexpectedly identified focal epileptiform abnormalities among multiple patients who presented with clinical features suggestive of parasomnia rather than epilepsy—they did not have a history of epileptic seizures or risk factors for epilepsy. The individual history of each patient and the type of abnormality are discussed in the context of any potential for increased cortical irritability.