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Christopher Paul Derry, MRCP; Samuel F. Berkovic, MD

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We agree with these authors that the Frontal Lobe Epilepsy and Parasomnias (FLEP) scale should not be used entirely in isolation: it is designed as an adjunct to, rather than a substitute for, a good clinical evaluation. However, NFLE is not common and, in practice, patients may present to a clinician with limited direct experience of the disorder; the scale may therefore be useful in this setting to assist in the diagnostic process, particularly when video electroencephalography monitoring is not achievable.¹

In terms of the structure of the scale, it is important to appreciate that it comprises a series of weighting factors and that none of the features listed is diagnostic in its own right. Thus, an age at onset older than 55 years would weight the diagnosis toward parasomnia (REM behavior disorder); if other clinical features were strongly suggestive . . . [Full Text of this Article]

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