A female aged 25 years, with a previous diagnosis of juvenile myoclonic epilepsy, already treated with valproate, complained about fragmented and agitated sleep with insomnia and jerks-like movements during sleep and excessive daytime somnolence. Her parents reported noises, movements and shouting. Previous EEG registration showed diffuse brief spike and waves discharges, moreover during photostimulation. The nocturnal video polysomnography showed some diffuse sharp-waves in wake and during sleep. During REM sleep diffuse jerks were present, sometimes with brief eyes opening and vocalization, without evident clear epileptiform activity. Manifestation like these ones, during REM phase, in this kind of patients, disrupting quality of sleep, are not reported. They could be physiological events of REM phase, manifestations of arousal or concomitant parasomnias.
