Clinical and EEG characteristics of sleep-related hypermotor epilepsy in children

Sleep-related hypermotor epilepsy (SHE) is a focal epilepsy with nocturnal hypermotor seizures. Although SHE was redefined in 2014, comprehensive pediatric studies are still lacking for this disorder. To address this need, here we describe the clinical and electroencephalography (EEG) characteristics of children with SHE.

We retrospectively enrolled pediatric patients with SHE diagnosis who were hospitalized at our institution from August 1, 2021, to August 31, 2023.

Among the 47 patients, 31.9 % and 42.6 % manifested as SP2 and SP3, respectively. A total of 57.4 % of the patients showed a focal discharge as diagnosed by interictal EEG, 36.2 % showed multifocal discharges, and 6.4 % did not have discharge. Ictal EEG revealed that 66.0 % of patients presented with frontal lobe onset, 10.6 % with temporal lobe onset, and 23.4 % with unknown onset. Further, 36.2 % of patients had a structural etiology, approximately 80 % of those patients had focal cortical dysplasia. Finally, 23 patients were diagnosed with refractory epilepsy, and 15 of them underwent surgery.

Patients mainly presented as SP3 and SP2. The focal discharges detected by interictal EEG accounted for approximately 57.4 % and the frontal lobe onset detected by ictal EEG accounted for approximately 66 %. Structural etiology (mainly focal cortical dysplasia) accounted for approximately 33 %, and surgery was an effective treatment for these patients.