![]() In the remaining families, the cause of the condition is unknown. In some cases, a gene other than those that make up the nAChR are involved. The genetic cause of ADNFLE has been identified in only a small percentage of affected families. Researchers are also working to determine why these seizures occur most often during sleep. It is unclear why mutations in the CHRNA2, CHRNA4, and CHRNB2 genes cause seizures in the frontal lobes rather than elsewhere in the brain. ![]() These regions of the brain are involved in many critical functions, including reasoning, planning, judgment, and problem-solving. The seizures associated with ADNFLE begin in areas of the brain called the frontal lobes. The resulting changes in signaling between neurons likely trigger the abnormal brain activity associated with seizures. Researchers believe that mutations in the CHRNA2, CHRNA4, and CHRNB2 genes affect the normal release and uptake of certain neurotransmitters in the brain. This receptor plays an important role in chemical signaling between nerve cells (neurons) in the brain.Ĭommunication between neurons depends on chemicals called neurotransmitters, which are released from one neuron and taken up by neighboring neurons. These genes provide instructions for making different parts (subunits) of a larger molecule called a neuronal nicotinic acetylcholine receptor (nAChR). Mutations in the CHRNA2, CHRNA4, and CHRNB2 genes can cause ADNFLE. It is unclear whether these additional features are directly related to epilepsy in these individuals. However, some people with ADNFLE have experienced psychiatric disorders (such as schizophrenia), behavioral problems, or intellectual disability. Most people with ADNFLE are intellectually normal, and there are no problems with their brain function between seizures. In most affected people, the seizures can be effectively controlled with medication. The episodes tend to become milder and less frequent with age. The seizures associated with ADNFLE can begin anytime from infancy to mid-adulthood, but most begin in childhood. Episodes may be triggered by stress or fatigue, but in most cases the seizures do not have any recognized triggers. It is unclear what brings on seizures in people with ADNFLE. Some affected people have also reported a feeling of breathlessness, overly fast breathing (hyperventilation), or choking. ![]() The most common symptoms associated with an aura in people with ADNFLE are tingling, shivering, a sense of fear, dizziness (vertigo), and a feeling of falling or being pushed. In some types of epilepsy, including ADNFLE, a pattern of neurological symptoms called an aura often precedes a seizure. These episodes are sometimes misdiagnosed as nightmares, night terrors, or panic attacks. The person may also cry out or make moaning, gasping, or grunting sounds. The person may get out of bed and wander around, which can be mistaken for sleepwalking. Others have more severe episodes that can include sudden, repetitive movements such as flinging or throwing motions of the arms and bicycling movements of the legs. ![]() Some people have mild seizures that simply cause them to wake up from sleep. The seizures characteristic of ADNFLE tend to occur in clusters, with each one lasting from a few seconds to a few minutes. Some people with ADNFLE also have seizures during the day. This disorder causes seizures that usually occur at night (nocturnally) while an affected person is sleeping. Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is an uncommon form of epilepsy that runs in families. ![]()
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