Nocturnal epilepsy is a seizure disorder in which seizures occur only while
sleeping. Several common forms of epilepsy, including frontal lobe
epilepsy, can manifest in a nocturnal state.
Epilepsy can be nocturnal if the form of epilepsy only triggers seizures while
one is asleep, or if one normally has seizures that occur at that time. In the
latter example, if the subject stays awake at a time when he is normally
sleeping, the subject may have the seizure while awake. Noting this, it is
important for the subject to maintain a proper sleeping cycle. Diverting from
proper sleep patterns can trigger more frequent epileptic symptoms in people
who are diagnosed with nocturnal epilepsy and as mentioned before, even
while awake. Diagnosis
The condition may be difficult to diagnose. The subject may be unaware she
is having a seizure disorder. To others, the involuntary movements made during
sleep may appear no different from those typical of normal sleep.People who have
nocturnal seizures may notice unusual conditions upon awakening in the
morning, such as a headache, having wet the bed, having bitten the tongue, a
bone or joint injury, muscle strains/weakness, fatigue or
light-headedness. Others may notice unusual mental behaviors consistent with
the aftermath of a seizure. Objects near the bed may have been knocked to the
floor, or the subject may be surprised to find themselves on the floor.
There are many risks associated with nocturnal seizures including concussion,
suffocation and SUDEP. It is often also very difficult to know how long the
seizure has been going. = Type =
A person who suffers from epilepsy regardless of whether it is nocturnal or
not, can be categorized into two different types of epilepsy either being
generalized, or partial. A generalized epilepsy syndrome is associated with an
overall hyperactivity in the brain, where electrical discharges occur all
over the brain at once; this syndrome often has a genetic basis. While
generalized epilepsy occurs all over the brain, partial epilepsy consists of a
regional or localized hyperactivity, which means that the seizures occur
conversely in one part of the brain or several parts at once.
Treatment Like other forms of epilepsy, noctural
epilepsy can be treated with anti-convulsants. Despite the
effectiveness of anti-convulsants in people who suffer from nocturnal
epilepsy, anti-convulsants are shown to disrupt a persons sleeping structure.
This may cause concern in people who suffer from specifically nocturnal
epilepsy because undisrupted sleep is important for these people, as it lowers
the likeliness of epileptic symptoms to arise. One particular study by V.
Bradley and D. O'Neill analysed the different forms of epilepsy, including
nocturnal epilepsy and its relationship with sleep. They found that some
patients only experienced epileptic symptoms while they are asleep, and that
maintaining good sleep helped in reducing epileptic symptoms. Another
study determined that anti-convulsant medications can minimize epilepsy not
just in people who are awake, but also in people who are asleep. However, some
of these anti-convulsant medications did also have adverse effects on subjects'
sleeping structures, which can exacerbate epileptic symptoms in people
who suffer from nocturnal epilepsy. To minimize epileptic seizures in these
people, it is important to find an anti-convulsant medication that does not
disrupt a person's sleeping structure. The anti-convulsant medications that
were tested to meet this criteria are: Phenobarbital, Phenytoin, Carbamazepine,
Valproate, Ethosuximide, Felbamate, Gabapentin, Lamotrigine, Topriamate,
Vigabatrin, Tiagabine, Levitiracetam, Zonisamide, and Oxcarbazepine.
Oxcarbazepine is shown to have the least amount of adverse effects on sleep.
Another study shows that it enhances slow wave-sleep and sleep continuity in
patients with epilepsy. References
Sources Manford, Mark, Practical Guide to
Epilepsy, Butterworth-Heinemann, ISBN 0-7506-4621-7