Brief nocturnal frontal lobe seizures with hyperkinetic, dystonic or tonic motor features occur. Hyperkinetic features comprise bipedal large amplitude frenetic movements such as kicking and climbing. There may be pelvic rocking. Seizures can manifest as nocturnal wandering. Seizures are of short duration (usually less than one minute; mean seizure duration of 30 sec) and cluster with multiple each night (mean of 8 seizures per night). Awareness is usually preserved through the seizure and there is no post-ictal state. Two thirds of patients experience a focal sensory or focal cognitive seizure before the motor features emerge. A sensation of being unable to catch a breath is frequently experienced during the seizure. Seizures from the wake state or focal to bilateral tonic-clonic seizures can occur but are rare, and usually are seen in the context of poor seizure control.
CAUTION Seizures predominantly from the awake state consider other epilepsy syndromes.