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Psychiatry · Eating and sleep disorders: nocturnal frontal lobe epilepsy
Sample itemA 22-year-old man has up to twenty brief nocturnal episodes a week in which he suddenly sits up, thrashes his legs and shouts, always in the same stereotyped way, each lasting under a minute. He is difficult to arouse afterward. Which test is most useful?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Video-polysomnography with extended EEG montage
Stereotyped, frequent, brief hypermotor events from sleep suggest nocturnal frontal lobe epilepsy, which is often mistaken for night terrors or sleepwalking. Parasomnias are less frequent, less stereotyped and arise from slow-wave sleep. Video-EEG polysomnography distinguishes them.
Option by option
A. Multiple sleep latency test
The multiple sleep latency test evaluates daytime sleepiness and narcolepsy.
B. Overnight pulse oximetry
Oximetry screens for sleep apnoea and does not identify seizures.
C. Video-polysomnography with extended EEG montage (correct)
Correct. Video-EEG polysomnography can capture the events and show epileptiform activity.
D. Actigraphy
Actigraphy measures rest and activity cycles, and cannot characterise these events.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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