Episodic nocturnal wanderings responsive to anticonvulsant drug therapy

Six patients between the ages of 17 and 32 years presented with unusual sleep-walking epidodes characterized by screaming or unintelligible vocalizations; complex, often violent automatisms; and ambulation. Two or more attacks could occur in a single night and were most common in the early morning hours. Family and personal histories did not show epilepsy, psychiatric disorders, or (with 1 exception) previous somnambulism. Electrographic investigation revealed that all patients had normal waking-sleep cycles but that 4 of them had epileptiform abnormalities on their electroencephalograms. All patients were treated with either phenytoin or carbamazepine, with cessation of the abnormal nocturnal behavior during follow-up periods ranging from 9 to 48 months. This syndrome appears to be distinct from more typical non-rapid eye movement dyssomnias and suggests an atypical form of epilepsy.