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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/she 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.
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 than those typical of normal sleep.
People who have of nocturnal seizures may notice some unusual differences upon awakening in the morning, such as a headache, having wet the bed, having bitten the tongue, a bone or joint injury, 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.
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.
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 involving Bradley. V and O'Neill. D, analysed the different forms of epilepsy including nocturnal epilepsy and its relationship with sleep. They found how some patients only experienced epileptic symptoms while they were asleep (nocturnal epilepsy), and that maintaining good sleep helped in reducing epileptic symptoms. Another study determined that anti-convulsant medications can be beneficial to minimize epilepsy in people who are not just awake, but people who are asleep. However, some of these anti-convulsant medications did also have adverse effects on peoples' sleeping structure, 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 can help alleviate epileptic symptoms, and not disrupt a persons 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. Within the chart that lists these medications, Oxcarbazepine is shown to have the least amount of adverse effects on sleep, and in another study, it says that it enhances slow wave-sleep and sleep continuity in patients with epilepsy.