| Diagnosis based on clinical history |
- Brief (<2 minutes) seizures with stereotyped motor pattern, abrupt onset and offset, may cluster
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- Most common motor activity is hypermotor: vigorous hyperkinetic movements, and/or asymmetric tonic or dystonic posturing, with or without impaired awareness
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- Occurrence predominantly during sleep
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- Diagnosis not excluded by intellectual impairment, neuropsychiatric features, absence of interictal and ictal EEG correlates, extrafrontal origin
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| Three levels of certainty |
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- Clinical features provided by observer
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- Video-documented (clinical)
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- At least one stereotyped event, confirmed by observer to be typical
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- High quality audio-video including the onset and offset with clear visualization of the entire event
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- Minor motor events or paroxysmal arousals excluded
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- Video-EEG documented (confirmed)
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- At least one stereotyped event during daytime sleep recording after sleep deprivation, or during full night sleep recording using ≥19 EEG channels, ECG, oculogram, and chin EMG
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- Definitive ictal epileptic discharge or interictal epileptiform abnormality
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