Autosomal dominant nocturnal frontal lobe epilepsy

Title

Other Names:

ADNFLE; Epilepsy, nocturnal frontal lobe, 1; ENFL1; ADNFLE; Epilepsy, nocturnal frontal lobe, 1; ENFL1; Autosomal dominant sleep-related hypermotor epilepsy See More

Categories:

Congenital and Genetic Diseases; Nervous System Diseases

Summary Summary

Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is an uncommon, inherited form of epilepsy. People with ADNFLE have seizures that usually occur at night during sleep. Some people with ADNFLE also have seizures during the day. These seizures can last from a few seconds to a few minutes, and can vary from causing simple arousal from sleep, to dramatic muscle spasms and movements. The onset of ADNFLE ranges from infancy to adulthood, but most cases begin in childhood. Episodes tend to become milder and less frequent with age.^[1]^[2] It is diagnosed based on symptoms and the results of tests such as an EEG. ADNFLE is inherited in an autosomal dominant manner and may be caused by a mutation in any of several genes. In most cases however, the genetic cause is not found. Seizures can usually be controlled with anti-seizure medications.^[2]

Last updated: 7/22/2015

Symptoms Symptoms

The main symptom in people with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is seizures that generally occur at night. Seizures may begin anywhere from early childhood to adulthood, but most often begin in childhood.^[3]^[4] Seizures may last from a few seconds to a few minutes.^[1] The frequency of seizures varies from several per year to several per night.^[3] Seizures may become less frequent or more mild as a person gets older.^[1] Some people with ADNFLE occasionally have seizures while they are awake.^[4]

When a person with ADNFLE is having a seizure, they may experience a variety of movement-related symptoms ranging from mild to severe. Examples include:^[1]^[3]^[4]

Short bursts of random, repetitive movements of the limbs, trunk, or head, lasting 2 to 4 seconds.
Brief, sudden arousal (waking), sometimes with repetitive movements, making sounds, crying, or feelings of fear.
Major attacks lasting 20 to 30 seconds, characterized by extreme stiffening of muscles, or movements such as pelvic thrusting, pedaling, twisting and writhing, or fast, forceful motions of the limbs.

Recurring episodes of exertion during the night may lead to sleepiness during the day.^[4]

Most people with ADNFLE have normal intellect (thinking abilities), but in some cases, intellect is reduced. Some people with ADNFLE also have psychiatric disorders or behavior problems, but it is unclear if these are directly related to ADNFLE.^[1]^[3]

Last updated: 7/22/2015

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms	Other Names	Learn More: HPO ID
5%-29% of people have these symptoms
Intellectual disability	Mental deficiency Mental retardation Mental retardation, nonspecific Mental-retardation [ more ]	0001249
Percent of people who have these symptoms is not available through HPO
Autosomal dominant inheritance		0000006
Childhood onset	Symptoms begin in childhood	0011463
Focal-onset seizure	Seizure affecting one half of brain	0007359
Incomplete penetrance		0003829

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Do you have more information about symptoms of this disease? We want to hear from you.

Last updated: 12/1/2020

Do you have updated information on this disease? We want to hear from you.

Diagnosis Diagnosis

A diagnosis of autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is made based on signs and symptoms. In addition to the doctor taking a detailed medical and family history from the person with symptoms, obtaining information from others who see episodes occur is very helpful. In some cases, video-EEG monitoring during sleep is needed.

The features that suggest a diagnosis of ADNFLE include:

Clusters of seizures that occur mainly during sleep.
A normal neurologic exam and normal findings on brain imaging tests.
A normal EEG recorded during a seizure (ictal EEG), or one that is obscured by movement of the cables or electrodes.
An EEG recorded between seizures (interictal EEG) that shows few or no instances of patterns seen in people with epilepsy.
The presence of the same disorder in other family members, with evidence of autosomal dominant inheritance.

If ADNFLE is suspected, genetic testing may be ordered. However, genetic testing can confirm the diagnosis in only 20% of people with a family history of ADNFLE, and in fewer than 5% of people with no family history.^[2]

Last updated: 1/17/2018

Testing Resources

The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional.

Find a Specialist Find a Specialist

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from Genetics Home Reference.

Related Diseases Related Diseases

Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Differential diagnoses include paroxysmal dyskinesia, familial focal epilepsy with variable foci, restless legs syndrome, periodic limb movement disorders (PLMS), REM sleep behavior disorders (RBD), nocturnal panic attacks, non-REM parasomnias, obstructive sleep apnea syndrome, and arousal disorders. Visit the Orphanet disease page for more information.

Organizations Organizations

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Epilepsy Action
New Anstey House Gate Way Drive
Yeadon, LEEDS LS19 7XY
United Kingdom
Telephone: 0113 210 8800 (UK) or +44 (0)113 210 8800 (international)
Fax: 0113 391 0300 (UK) or +44 (0)113 391 0300 (international)
E-mail: epilepsy@epilepsy.org.uk
Website: https://www.epilepsy.org.uk/
Epilepsy Foundation
8301 Professional Place East
Suite 230
Landover, MD 20785
Toll-free: 800-332-1000 (24/7 Helpline)
Telephone: +1-301-459-3700
Fax: +1-301-577-2684
E-mail: contactus@efa.org
Website: https://www.epilepsy.com/
en Español 1-866-748-8008

Do you know of an organization? We want to hear from you.

Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

Genetics Home Reference contains information on Autosomal dominant nocturnal frontal lobe epilepsy. This website is maintained by the National Library of Medicine.

In-Depth Information

GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions.
Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.

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Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

I jump in my sleep every night. Is this a sign that I have autosomal dominant nocturnal frontal lobe epilepsy? Some nights it is worse than others. I actually raise off of the bed. See answer

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References References

ADNFLE. Genetics Home Reference. April, 2009; http://ghr.nlm.nih.gov/condition/autosomal-dominant-nocturnal-frontal-lobe-epilepsy.
Hirokazu Kurahashi and Shinichi Hirose. Autosomal Dominant Nocturnal Frontal Lobe Epilepsy. GeneReviews. February 19, 2015; http://www.ncbi.nlm.nih.gov/books/NBK1169/.
Hirose S, Kurahashi H. Autosomal dominant nocturnal frontal lobe epilepsy. Orphanet. December, 2014; http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=en&Expert=98784.
Nobili L, Proserpio P, Combi R, et al. Nocturnal Frontal Lobe Epilepsy. Current Neurology and Neuroscience Reports. February, 2014; 14:424. https://link.springer.com/article/10.1007%2Fs11910-013-0424-6#Sec5.