Residents and Fellows

A 26-year-old woman presents with a history of arousals from sleep with uncontrollable movements since 13 years of age. The episodes abruptly awaken her every night, sometimes multiple times, usually beginning as soon as she starts to fall asleep. She describes a feeling of panic and moves around in bed in an uncontrollable manner, grasping at the bed sheets and turning from side to side for 10 to 20 seconds. She has full recall of the episodes. Rarely, similar episodes occur when she naps during the day. On several occasions, she has presented to the emergency room during the night when frequent episodes prevent her from sleeping. She had a normal birth and development and denies a personal history of febrile convulsions, head trauma, and CNS infections or a family history of epilepsy. Over the years, she has been treated with several antiepileptic drugs, including carbamazepine, lamotrigine, gabapentin, and lacosamide, without improvement. The clinical semiology, EEG recording and SPECT study depicted during the event are most consistent with which of the following diagnoses?