Epilepsy Talk

The nightmare of nocturnal seizures | October 13, 2024

According to an article in Journal of Neurology, Neurosurgery & Psychiatry, if more than 90 percent of your seizures occur while sleeping, you are said to have sleep seizures.

The article also notes that an estimated 7.5 percent to 45 percent of people who have epilepsy have some form of nocturnal seizures.

Since seizures occur in sleep during the night, it’s often hard to diagnose them, except for unusual movements at night, confusion upon awakening, bed wetting or falling out of bed.

However, these symptoms are also a kind of parasomnia — an umbrella term for a group of sleep disorders that include night terrors, sleepwalking, teeth grinding, and restless leg syndrome.

It’s believed that sleep seizures are triggered by changes in the electrical activity in your brain during the stages of sleeping and awakening. Most nocturnal seizures occur in stage 1 and stage 2, which are the stages of lighter sleep.

And nocturnal awakenings are sometimes confused with insomnia. Epilepsy patients are often unaware of the seizures that occur while they sleep.

They may suffer for years from daytime fatigue and concentration problems without ever knowing why.

In contrast, panic attacks typically occur within three hours of sleep onset and are most commonly seen in the transition from stage 2 to stage 3 sleep.

And after these night terrors, which are accompanied by screaming and intense fear, the person falls back to sleep and sometimes has no recollection of the episode when awakening in the morning, except in some cases, waking with a bitten tongue or a disordered bed.

Other people can recall the episode in the morning and this frequently leads to dread and anticipation of another attack.

Nocturnal seizures are associated with certain types of epilepsy, including:

Juvenile myoclonic
Awakening grand mal
Benign rolandic (also called benign focal epilepsy of childhood)
Electrical status epilepticus of sleep
Landau-Kleffner syndrome (LKS)
Frontal onset seizures

Doctors evaluate a number of factors to diagnose epilepsy and determine the type. Factors include:
The type of seizures you have
The age when you began having seizures
Family history of epilepsy

To diagnose epilepsy, doctors may use:
Images of electrical activity in your brain recorded by an electroencephalogram (EEG). The structure of your brain as shown in a computed tomography (CT) scan. Or magnetic resonance imaging (MRI), a record or diary of your seizure activity.

Sleep studies (Polysomnography) with expanded EEG aids can indicate the difference between seizures and parasomnias.

If being observed in a sleep lab, there is a decrease in rapid eye movement (REM) and an increase in the lighter stages of sleep, according to the article “Nocturnal Seizures,” by Carl W. Bazil, MD, PhD.

It doesn’t take the fear away, but it can help diagnose and treat the nightmare of sleep seizures.

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Resources:
https://www.healthline.com/health/epilepsy/nocturnal-seizures#sleep-seizures

https://www.medicalnewstoday.com/articles/326864

http://sleepfoundation.org/sleep-disorders-problems/disease-and-sleep/epilepsy

http://www.clinicaladvisor.com/consider-nocturnal-seizures-when-evaluating-a-patient-for-parasomnias/article/267859/

https://www.cedars-sinai.org/health-library/diseases-and-conditions/n/nocturnal-seizures.html

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