An arousal is an event that triggers a spectrum of behaviors that look the same whether they are part of a seizure or of a parasomnia/sleep motor event. The latter include locomotion, self-defense, feeding and reproductive behaviors critical for survival.Īccording to the “Triune” brain theory by MacLean (Reiner, 1990), they are the expression of the disinhibition of more primitive layers of the human brain, the limbic or paleopallium, and the midbrain or reptilian brain, which under certain conditions may escape the control of our most elaborate brain, the neopallium (see Fig. These networks named Central Pattern Generators (CPGs) are able to promote a spectrum of species-specific self-sustained patterns of archetypical behaviors. Brown in 1911 (Tassinari et al., 2012), can generate coordinated rhythmic movement patterns. Tassinari, claimed that genetically determined motor neural networks embedded in the spinal cord and brainstem of primates, first described by T.G. Specific treatment options for the aforementioned disorders are beyond the scope of this article.Īn Italian neurologist, C.A. In most cases rhythmic movements, especially when complex and long in duration, are related to different levels of arousal from sleep with recurrence of ancestral motor sequences promoted by central pattern generators in the brainstem, generally activated by the arousal process.Ī differential diagnosis between physiological events and pathological movement disorders, and between the latter and sleep-related epilepsy is critical to provide optimal treatment and an accurate prognosis. They may also characterize some frontal or temporal nocturnal seizures of sleep-related hypermotor epilepsy, or be considered as part of NREM parasomnias, especially sleepwalking, sexsomnia or sleep-related eating disorder, or REM-related behaviors such as REM behavior disorder or complex movements associated with pediatric narcolepsy type I. Rhythmic movements during sleep may occur in the context of physiological sleep-related motor activity or be part of sleep-related movement disorders such as bruxism, periodic limb movement disorder, restless legs syndrome, and sleep-related rhythmic movement disorder.
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