Sleep Related Seizures

What is a seizure disorder?

  • The brain “runs on” chemical/ electrical energy. In some people, certain brain cells “discharge”, activating yet other brain cells and so on, in an inappropriate way.
  • This abnormal spread of electrical activity in the brain is the basis of a seizure.

Do people with seizures always have convulsions?

No. While some people do, many individuals never have anything approaching or resembling a full-blown convulsion during their seizures. The symptoms of each seizure depend entirely upon the specific parts of the brain that are activated by the abnormal bursts of electrical activity. For example, a seizure involving the brain area involved with:

  • Sense of taste – may result in perception of a peculiar taste that is not really there: often metallic, like a piece of foil or a penny in one’s mouth.
  • Sense of smell – may result in a peculiar odor, typically the same, usually foul or unpleasant and not noted by others.
  • Vision – may cause objects to appear too large, too small, distorted or otherwise abnormal.
  • Control of muscles – may cause jerking of the opposite side of the body or face.

Why are seizures relevant when one is dealing with sleep problems?

SEIZURES CAN CAUSE CLOUDING OF CONSCIOUSNESS AND IMPAIRED ALERTNESS RESEMBLING SLEEPINESS IN SOME INDIVIDUALS. Some people who experience lapses, confusion and slowed thinking–and who thus assume that they are simply sleepy–actually are not. Instead, they are experiencing low grade seizure activity that is interfering with their mental functioning. It is critical to differentiate this type of problem from true sleepiness, because its treatment is totally different.

SEIZURES OFTEN OCCUR DURING DURING SLEEP – AND THE CONSEQUENT SYMPTOMS CAN MIMIC WHAT ONE ENCOUNTERS WITH OTHER SLEEP-RELATED ILLNESSES. During sleep, the brain tends to “let its guard down”: facilitating the occurrence of a number of different types of seizure manifestations. Examples range from mild twitches of one side of the face to repetitive hard body jerks, bizarre attacks of screaming and frantic behavior, and even generalized convulsions. Loss of urine, generalized muscle aching on awakening, and biting of the inside of the cheek or the tongue during sleep suggest, but don’t prove, that a seizure took place.

What clues should make one suspect that unexplained symptoms might be due to a seizure disorder?

Any of the above-mentioned symptoms or behaviors, particularly if they are stereotyped (meaning that they are virtually the same every time that they occur). For example:

  • Abnormal tastes, smells or sensations that are always identical whenever experienced.
  • Characteristic facial expressions–usually with a blank stare, fumbling with the hands, chewing, licking of the lips or other behaviors that always look just about the same.
  • Movements that always involve the same side of the body. For example:¬†Eyes or head always turn to the same side, or face always draws to the same side or jerking always begins in the same arm or leg.
  • Staring spells that involve any of the following:
    • Pupils get large, or eyes open widely (the opposite of what would expect in a sleepy individual)
    • Face gets pale
    • No response to name being called
    • Failure to blink if a hand is waved in front of the person’s face
  • Feelings of abnormal familiarity (deja vu) or unfamiliarity (jamais vu), if unusually frequent or intense
  • Symptoms that are extremely difficult to put into words
  • Confusion or sleepiness after the symptoms occur

Who can develop a seizure disorder?

Persons of all ages: regardless of their sex, race, intelligence, etc.

  • SEIZURES ARE AMONG THE COMMONEST DISORDERS OF THE BRAIN. Failure to consider them as possibilities when evaluating people with sleep problems would be unrealistic–and most unfair to the patient, since they are usually very treatable.
  • MANY DIFFERENT CAUSES can account for the development of seizure disorders. In some cases, they “run in families”. They can be caused by lack of oxygen or low blood sugar levels in sleep, other metabolic problems, head injuries, other structural problems in the brain, and by a wide variety of other factors. Frequently, no cause can be identified.

If there are indications that your problems with sleep or alertness might be due to an underlying seizure disorder, what should you do?

ENSURE THAT YOU ARE EVALUATED AT A SLEEP CENTER THAT IS FULLY STAFFED AND EQUIPPED FOR THE EVALUATION AND MANAGEMENT OF SEIZURES!

  • Many sleep centers (and, by definition, all sleep laboratories for breathing disorders) cannot perform full EEG (“brain wave”) monitoring during sleep. Their recording techniques instead are limited to identifying sleep stages rather than abnormal bursts of brain electrical activity.
  • If you have symptoms that suggest that you may have a seizure disorder, it would be important to ask several key questions of any sleep facility before proceeding with care.

Does the center have a neurologist (specialist in disorders of the brain and nervous system) on staff?

  • If so, does that neurologist interpret overnight sleep recordings?
  • Does the center have the necessary equipment and staff expertise for the performance of full electroencephalography throughout sleep recordings?
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