Background: Behavioral disturbances in sleep may arise from several causes, among which are REM behavior disorder, nocturnal panic attacks and seizures. When associated with flinging movements
of the arms and legs, seizure disorder has to be considered.Case Report: A young Chinese man presented with two episodes of nocturnal behavioral disorder in sleep. Both episodes were consistent with nocturnal paroxysmal dystonia, a manifestation of nocturnal frontal lobe epilepsy (NFLE). Magnetic resonance imaging of the brain showed a right frontal lobe lesion for which tailored frontal lobectomy was performed. Histologic examination revealed a WHO grade II oligodendroglioma. He was commenced on Phenytoin prophylaxisand has had no recurrence of seizures postoperatively.Conclusions: This case highlights the importance of recognizing frontal lobe seizures as a cause of behavioral disorders in sleep, as well as the usefulness of neuroimaging studies in patients with adult-onset NFLE.

Keywords: Nocturnal, frontal lobe epilepsy, tumor