Nocturnal Seizures

As a subset of epilepsy, nocturnal seizures amplify one of the major problems of epilepsy in general: episodes are less likely to be directly witnessed than daytime seizures, and therefore diagnosis and characterization are more difficult. As a sleep problem, nocturnal seizures are not benign, and the resulting sleep disruption can cause daytime somnolence and concentration difficulty. This article outlines three major topics in nocturnal seizures: differential diagnosis (distinguishing between seizures and parasomnias), the effects of nocturnal seizures on sleep structure, and specific syndromes of primarily or exclusively nocturnal seizures.

KEYWORDS

Sleep - seizure - epilepsy - juvenile myoclonic epilepsy - frontal lobe - benign Rolandic epilepsy - polysomnography

REFERENCES

• 1 Guilleminault C, Montplaisir J, Billiard M, Dement W C. Automatic behavior syndrome in patients with excessive daytime somnolence.  Electroencephalogr Clin Neurophysiol. 1975;  39 432-433
• 2 Broughton R J. Behavioral parasomnias. In: Chokroverty S, Daroff RB Sleep Disorders Medicine Boston; Butterworth Heinemann 1999: 635-660
• 3 National Sleep Foundation .2001 Sleep in America Poll. Washington, DC; National Sleep Foundation 2001
• 4 Chervin R D, Guilleminault C. Obstructive sleep apnea and related disorders.  Neurol Clin. 1996;  14 583-609
• 5 Malow B A, Levy K, Maturen K, Bowes R. Obstructive sleep apnea is common in medically refractory epilepsy patients.  Neurology. 2000;  55 1002-1007
• 6 Devinsky O, Ehrenberg B, Barthlen G M, Abramson H S, Luciano D. Epilepsy and sleep apnea syndrome.  Neurology. 1994;  44 2060-2064
• 7 Kales A, Soldatos C R, Caldwell A B et al.. Somnambulism: clinical characteristics and personality patterns.  Arch Gen Psychiatry. 1980;  37 1406-1410
• 8 Bixler E O, Kales A, Soldatos C R, Kales J D, Healey S. Prevalence of sleep disorders in the Los Angeles metropolitan area.  Am J Psychiatry. 1979;  136 1257-1262
• 9 Klackenberg G. Somnambulism in childhood-prevalence, course and behavioral correlates: a prospective longitudinal study (6-16 years).  Acta Paediatr Scand. 1982;  71 495-499
• 10 Mahowald M W, Schenck C H. NREM sleep parasomnias.  Neurol Clin. 1996;  14 675-696
• 11 Strang R R. The symptoms of RLS.  Med J Aust. 1967;  1 1211-1213
• 12 Lavigne G J, Montplaisir J Y. Restless legs syndrome and sleep bruxism: prevalence and association among Canadians.  Sleep. 1994;  17 739-743
• 13 Bixler E O, Kales A, Vela-Bueno A, Jacoby J A, Scarone S, Soldatos C R. Nocturnal myoclonus and nocturnal myoclonic activity in the normal population.  Res Commun Chem Pathol Pharmacol. 1982;  36 129-140
• 14 Ancoli-Israel S, Kripke D F, Mason W, Kaplan O J. Sleep apnea and periodic movements in an aging sample.  J Gerontol. 1985;  40 419-425
• 15 Mosko S S, Dickel M J, Paul T et al.. Sleep apnea and sleep-related periodic leg movements in community resident seniors.  J Am Geriatr Soc. 1988;  36 502-508
• 16 Bannerman C. Sleep disorders in the later years.  Postgrad Med. 1988;  84 265-274
• 17 Trenkwalder C, Walters A S, Hening W. Periodic limb movements and restless legs syndrome.  Neurol Clin. 1996;  14 629-650
• 18 Overeem S, Mignot E, van Dijk J G, Lammers G J. Narcolepsy: clinical features, new pathophysiologic insights, and future perspectives.  J Clin Neurophysiol. 2001;  18 78-105
• 19 Bassetti C, Aldrich M. Narcolepsy.  Neurol Clin. 1996;  14 545-571
• 20 Guilleminault C, Wilson R A, Dement W C. A study on cataplexy.  Arch Neurol. 1974;  31 255-261
• 21 Robinson A, Guilleminault C. Narcoleosy. In: Chokroverly S, Daroff RB Sleep Disorders Medicine. Boston; Butterworth 1999: 427-440
• 22 Hublin S, Kaprio J, Partinen M et al.. The prevalence of narcolepsy: an epidemiological study of the Finnish twin cohort.  Ann Neurol. 1994;  35 709-716
• 23 Billiard M, Alperovitch A, Perot C et al.. Excessive daytime somnolence in young men: prevalence and contributing factors.  Sleep. 1987;  10 297-305
• 24 Dahlitz M , Parkes J D. Sleep paralysis.  Lancet. 1993;  341 406-407
• 25 Roth B, Buuhova S, Berkova L. Familial sleep paralysis.  Schweiz Arch Neurol Neurochir Psychiatr. 1968;  102 321-330
• 26 Aldrich M. The clinical spectrum of narcolepsy and idiopathic hypersomnia.  Neurology. 1996;  46 393-401
• 27 Schenck C H, Bundlie S R, Mahowald M W. Human REM sleep chronic behavior disorders: a new category of parasomnia.  Sleep Research. 1985;  14 208
• 28 Schenck C H, Bundlie S R, Patterson A L, Mahowald M W. Rapid eye movement sleep behavior disorder: a treatable parasomnia affecting older adults.  JAMA. 1987;  257 1786-1789
• 29 Olson E J, Boeve B F, Silber M H. Rapid eye movement sleep behaviour disorder: demographic, clinical and laboratory findings in 93 cases.  Brain. 2000;  123(Pt 2) 331-339
• 30 Husain A M, Miller P P, Carwile S T. REM sleep behavior disorder: potential relationship to post-traumatic stress disorder.  J Clin Neurophysiol. 2001;  18(2) 148-157
• 31 Schenck C H, Mahowald M W. REM sleep parasomnias.  Neurol Clin. 1996;  14 697-720
• 32 Besset A. Influence of generalized seizures on sleep organization. In: Sterman MB, Shouse MN, Passouant P Sleep and Epilepsy New York; Academic Press 1982: 339-346
• 33 Touchon J, Baldy-Moulinier M, Billiard M, Besset A, Valmier J, Cadilhac J. Organisation du sommeil dans l'epilepsie récente du lobe temporal avant et après traitment par carbamazepine.  Rev Neurol. 1987;  143 462-467
• 34 Tachibana N, Shinde A, Ikeda A, Akiguchi I, Kimura J, Shibasaki H. Supplementary motor area seizure resembling sleep disorder.  Sleep. 1996;  19(10) 811-816
• 35 Crespel A, Baldy-Moulinier M, Coubes P. The relationship between sleep and epilepsy in frontal and temporal lobe epilepsies: practical and physiopathologic considerations.  Epilepsia. 1998;  39(2) 150-157
• 36 Bazil C W, Castro L HM, Walczak T S. Reduction of rapid eye movement sleep by diurnal and nocturnal seizures in temporal lobe epilepsy.  Arch Neurol. 2000;  57 363-368
• 37 Touchon J, Baldy-Moulinier M, Billiard M et al.. Sleep organization and epilepsy. In: Degen R, Rodin EA Epilepsy, Sleep, and Sleep Deprivation Amsterdam; Elsevier 1991: 73-81
• 38 Bazil C W, Walczak T S. Effects of sleep and sleep stage on epileptic and nonepileptic seizures.  Epilepsia. 1997;  38(1) 56-62
• 39 Herman S T, Walczak T S, Bazil C W. Distribution of partial seizures during the sleep-wake cycle: differences by seizure onset site.  Neurology. 2001;  56 1453-1458
• 40 Park S A, Lee B I, Lee S J, Kim W J, Lee J H, Kim J Y. Clinical courses of pure sleep epilepsies.  Seizure. 1998;  7 369-377
• 41 Yaqub B A, Waheed G, Kabiraj M M. Nocturnal epilepsies in adults.  Seizure. 1997;  6 145-149
• 42 Malow B A, Passaro E A, Hall J H et al.. Sleep deprivation does not increase seizure frequency during long term monitoring.  Epilepsia. 1999;  40(suppl 7) 99-100
• 43 Quigg M, Straume M, Menaker M, Bertram E H. Temporal distribution of partial seizures: comparison of an animal model with human partial epilepsy.  Ann Neurol. 1998;  43 748-755
• 44 Bazil C W, Short D W, Crispin D, Zheng W. Patients with intractable epilepsy have low melatonin, which increases following seizures.  Neurology. 2000;  55 1746-1748
• 45 Fauteck J D, Schmidt H, Lerchl A, Kurlemann G, Wittkowski W. Melatonin in epilepsy: first results of replacement therapy and first clinical results.  Biol Signals Recept. 1999;  8 105-110
• 46 Peled N, Shorer Z, Peled E, Pillar G. Melatonin effect on seizures in children with severe neurologic deficit disorders.  Epilepsia. 2001;  42 1208-1210
• 47 Wolf P, Schmitt J J. Awakening epilepsies and juvenile myoclonic epilepsy. In: Bazil CW, Malow BA, Sammaritano MR Sleep and Epilepsy: The Clinical Spectrum Elsevier; Amsterdam 2002: 237-243
• 48 Shinnar S, Berg A T, Moshe S L et al.. Discontinuing antiepileptic drugs in children with epilepsy: a prospective study.  Ann Neurol. 1994;  35 534-545
• 49 Blom S, Heijbel J, Bergfors P G. Benign epilepsy of children with centro-temporal EEG foci. Prevalence and follow-up study of 40 patients.  Epilepsia. 1972;  13 609-619
• 50 Blom S, Heijbel J. Benign epilepsy of children with centro-temporal EEG foci. Discharge rate during sleep.  Epilepsia. 1975;  16 133-140
• 51 Hirsch E, Marescaux P, Maquet P et al.. Landau-Kleffner syndrome: a clinical and EEG study of five cases.  Epilepsia. 1990;  31 756-767
• 52 O’Regan M E, Brown J K, Goodwin G M, Clarke M. Epileptic aphasia: a consequence of regional hypometabolic encephalopathy?.  Dev Med Child Neurol. 1998;  40 508-516
• 53 Mendez M, Radtke R A. Interactions between sleep and epilepsy.  J Clin Neurophysiol. 2001;  18 106-127
• 54 Provini F, Plazzi G, Tinuper P, Vandi S, Lugaresi E, Montagna P. Nocturnal frontal lobe epilepsy. A clinical and polygraphic overview of 100 consecutive cases.  Brain. 1999;  122 1017-1031
• 55 Oldani A, Zucconi M, Asselta R et al.. Autosomal dominant nocturnal frontal lobe epilepsy. A video-polysomnographic and genetic appraisal of 40 patients and delineation of the epileptic syndrome.  Brain. 1998;  121 205-223