Crisi focali morfeiche con sintomatologia affettiva: Diagnosi differenziale

Nocturnal paroxysmal events with affective symptomatology may have various etiologies. Epileptic seizures with affective semiology in childhood consisting of brief and sudden panic symptoms associated with interictal spike-waves complexes in temporal regions. We describe three patients of (A) 6, (B) 5 and (C) 14 years old with paroxysmal nocturnal events in differential diagnosis with pavor nocturnes/panic attack/gastroesophageal reflux. In all the patients epilepsy started in preschool age with stereotyped episodes characterized by sudden awakening, terrifying expression, myoclonus palpebral uni/bilateral, and in B and C autonomic symptoms. Serial video-EEG showed seizures starting from the temporal regions. All the patients showed an evolution almost insensitive to drug therapy with spontaneous improvement. The neuroimaging showed no significant alterations. The stereotypical and overlapping characteristics of seizures and the lack of sensitivity to therapy appear to be suggestive of an age-related electro-clinical entity with unknown etiology and spontaneous benign course, as already suggested in the literature.