Episodic nocturnal wanderings in non-epileptic young patients

Twelve patients, aged 19 to 29 years, presented with episodic nocturnal wanderings characterized by stereotyped frequent attacks of screaming, ambulation, and complex automatisms during sleep. The attacks ranged in frequency from two or three per year to several per night and were often associated with semi-purposeful violent and even life-threatening behavior. None of the patients had a history of seizures; three had a history of prior parasomnias and four had family members with a history of parasomnia. Polysomnographic and daytime electroencephalographic (EEG) investigations showed potentially epileptiform activity in four patients. Recorded episodes were not accompanied by ictal EEG activity. Anticonvulsant medication reduced or eliminated the attacks in all of the nine treated patients. The pathophysiology of the disorder is uncertain.