INTRODUCTION Rapid eye movement (REM) sleep has an inhibitory effect on epileptiform EEG discharges, and seizures occur extremely rarely in REM sleep. CASE STUDY We present the case and video recordings of a 10-year-old boy, with sleep-related hypermotor seizures starting from REM sleep, identified from videoEEG recordings. The semiology comprised intense fear, tachycardia, tachypnea, followed by hypermotor manifestations. Further investigations included brain MRI and source localization of the EEG signals. Multiple antiepileptic drugs were tried, the patient obtaining a good control of the seizures in the last 2.5 years with eslicarbazepine. DISCUSSION AND CONCLUSION The ictal EEG source imaging showed seizure onset in the anterior part of the right insula, with propagation to the orbitofrontal area, confirmed by the semiological sequence. Although rare, focal seizures can be triggered by REM sleep and our findings suggest that deficient maturation of brain areas involved in sleep modulation might induce insufficient desynchronization during REM sleep, thus allowing seizure emergence.

中文翻译：

---

REM 睡眠相关的过度运动性癫痫发作：视频记录和发作源成像

简介 快速眼动 (REM) 睡眠对癫痫样脑电图放电具有抑制作用，并且在 REM 睡眠中极少发生癫痫发作。案例研究 我们展示了一个 10 岁男孩的病例和视频记录，从 REM 睡眠开始，从视频脑电图记录中识别出与睡眠相关的过度运动性癫痫发作。符号学包括强烈的恐惧、心动过速、呼吸急促，然后是运动过度的表现。进一步的研究包括脑 MRI 和 EEG 信号的源定位。尝试了多种抗癫痫药物，患者在过去 2.5 年中使用艾司利卡西平获得了良好的癫痫发作控制。讨论与结论 发作期脑电图源成像显示癫痫发作在右侧岛叶前部，并蔓延至眶额区，经符号学序列证实。