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The authors present the cases of six patients suffering from sudden, periodical (paroxysmal) awakenings several times a night. Often, the patients were upset by images of terrifying animals or people. Obvious causes of wakening, such as myoclonus or breathing obstruction were ruled out. The patients were admitted to a sleep laboratory and polysomnographic recordings were made while the patients were visually observed. The paroxysmal awakenings were found to occur during non-REM sleep, especially during slow-wave sleep. In one patient, the arousals were associated with EEG waves typical of epilepsy; this patient was also observed to have tonic-clonic seizures during sleep. However, epileptic discharges were not observed in the other five patients. In two patients, treatment with carbamazepine, an antiepileptic drug, was effective in suppressing the arousals. In the remaining patients, various anti-epileptic drugs were not effective. The cases bear some resemblance to pavor nocturnus (Latin for 'night terrors') in that they occurred during non-REM sleep with a normal EEG. However, the paroxysmal arousals in the present cases were unusually frequent and of short duration, sometimes lasting only a few seconds. Even though carbamazepine was effective in only two cases, the authors suggest that some sort of deep epileptic mechanisms might be at work. In another form of sleep disturbance, nocturnal paroxysmal dystonia, epileptic discharges may be detected with implanted electrodes which are not apparent when using scalp electrodes. Similar deeper epileptiform discharges may be involved in these cases, as well. (Consumer Summary produced by Reliance Medical Information, Inc.)