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Autosomal Dominant Nocturnal Frontal Lobe Epilepsy

Overview

Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is a rare genetic condition characterised by seizures that primarily occur during sleep. It originates from the frontal lobe of the brain and is inherited in an autosomal dominant pattern. Thus, there is up to a 75% likelihood of the genetic mutation being transferred to the offspring.

The seizures in ADNFLE are brief but can happen many times during the night. Symptoms may include:

  • Seizures during sleep
  • Hand clenching
  • Arm raising or lowering
  • Vocalisations such as shouting, grunting, or gasping
  • Sense of fear or panic
  • Dizziness

ADNFLE is caused by mutations (genetic changes) in certain genes (CHRNA2, CHRNA4, and CHRNB2) that regulate brain signalling. These genes affect receptors involved in communication between nerve cells, leading to abnormal electrical activity and seizures. The likelihood of ADNFLE increases due to the following:

  • Being born with brain abnormalities
  • Family history of seizures or epilepsy
  • Developmental disability
  • Brain infections or infections
  • Seizures in infancy or early childhood

Doctors diagnose ADNFLE through: 

  • Clinical examination and family history: To look for genetic inheritance patterns.
  • Electroencephalogram (EEG): A test that records brain’s electrical activity to detect seizure patterns, especially during sleep.

ADNFLE can usually be managed effectively with:

  • Antiseizure medications: To reduce frequency and severity of seizures.
  • Lifestyle measures: Maintaining regular sleep schedules and avoiding seizure triggers (like sleep deprivation, stress, or alcohol).

Consult a doctor if:

  • You or your child experience repeated unusual movements, sounds, or behaviours during sleep.
  • Seizures cause frequent awakenings or injuries.
  • There is a strong family history of epilepsy.

Since ADNFLE is genetic, it cannot be fully prevented. However, genetic counselling can help families understand their risk of passing it to children.

For proper diagnosis and treatment, consult a Neurologist (specialist in brain and nerve disorders).

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.