睡眠相关过度运动性癫痫诊疗进展OA

Sleep-related hypermotor epilepsy(SHE),previously termed nocturnal frontal lobe epilepsy(NFLE),is a focal epilepsy syndrome char-acterized by hypermotor seizures or asymmetric tonic/dystonic posturing occurring predominantly during sleep.SHE has heterogeneous etiologies,in-cluding genetic factors,structural brain lesions,and unknown causes.Although seizures in SHE com-monly originate from the frontal lobe,extrafrontal seizure onset zones—such as the insular,temporal,or parietal regions—have also been identified.Clini-cally,diagnosis largely depends on detailed seizure history and typical ictal video-EEG recordings.How-ever,scalp EEG often fails to provide specific find-ings due to movement artifacts or deeply localized seizure foci,presenting considerable diagnostic challenges.In terms of treatment,carbamazepine remains the first-line medication,but alternative drugs such as oxcarbazepine,topiramate,la-cosamide,and perampanel offer additional thera-peutic options.Advances in our understanding of nicotinic acetylcholine receptor(nAChR)involve-ment in SHE pathogenesis have prompted explo-ration of receptor-modulating treatments,such as nicotine patches and fenofibrate,though robust clinical evidence remains limited.For patients with drug-resistant SHE and clearly defined focal struc-tural lesions,epilepsy surgery is an effective option,often leading to excellent seizure outcomes.De-spite recent progress in diagnosis and management,substantial gaps and challenges persist in the un-derstanding and treatment of SHE,underscoring the need for further research to improve patient out-comes and quality of life.