Even though the origin and nature of nocturnal paroxysmal dystonia (NPD) remains unclear, it has been considered as a manifestation of the nocturnal frontal lobe epilepsy. We report a 17-year-old man with abnormal stereotyped movement during sleep. Video-EEG monitoring, ictal SPECT and night polysomnography did not show any evidence of epilepsy. However, the partial response to large dose of carbamazepine and the scoring according to the frontal lobe epilepsy and parasomnias (FLEP) scale suggest his events could be classified as epilepsy. Therefore we think the FLEP scale might be a useful tool for differential diagnosis in a patient presenting NPD.
