Reply

Abstract

To the Editor: There is no disagreement with these writers' observations, but I need to apologize for evidently failing to be sufficiently clear in my short paper. The table describes only differences between confusional arousals with the common night terrors and with those observed, as stated, in four children with sleep events proven to be of epileptic orgin within the frontal lobe. I provisionally termed these “epileptic night terrors.” Neither the table nor the Discussion section were meant to include all nocturnal paroxysmal events that begin with feelings of fear. The latter of course are not uncommon, as, for instance, in complex partial seizures such as those manifested by the child they describe, and which from the history, the amnesia, and their occurrence also in wakefulness, would have strongly suggested their epileptic nature and a likely origin from mesial temporal lobe structures, as it was eventually proven. Hence, I agree with their conclusions that nocturnal events starting with expressions of fearfulness may be epileptic seizures arising from the temporal lobe. These have several characteristics, such as unresponsiveness, frequent automatisms, amnesia, longer duration, often postictal confusion, and daytime incidence, which are all features that did not occur in my patients.