Nocturnal epilepsy

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Nocturnal epilepsy is a seizure disorder in which seizures occur only while sleeping.[1] Several common forms of epilepsy, including frontal lobe epilepsy, can manifest in a nocturnal state.

Epilepsy can be nocturnal if the form of epilepsy one has only triggers seizures while one is asleep, or if one normally has seizures that occur at the same time. In the latter example, if one stays awake at a time when s/he is usually asleep, s/he can have the seizure while awake. Noting this, it is important for s/he to maintain a proper sleeping cycle or structure. Diverting away from proper sleep can trigger more frequent epileptic symptoms in people who are diagnosed with nocturnal epilepsy and as mentioned before, even while they are awake.[2]

Diagnosis[edit]

The condition may be difficult to diagnose. The subject himself/herself may be unaware s/he is having a seizure disorder.[3] To others, the involuntary movements made during sleep may appear no different than those typical to normal sleep.[4]

One who suffers a nocturnal seizure may notice some unusual differences upon awakening in the morning, such as a headache, having wet his/her bed, having bitten his/her tongue, a bone or joint injury, or lightheadedness. Others may notice unusual mental behaviors with the person, consistent with the aftermath of a seizure.[5] There may also be objects in the vicinity of the bed knocked on the floor, or the subject him/herself may be surprised to find him/herself on the floor.

A possible risk of any nocturnal seizure is that a concussion, possibly a significant one, could occur and the patient thus would be in danger and might not know it until late in the process.

Categorizing the type of Epilepsy[edit]

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.[6] 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.[7] 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.[8]

Treatment[edit]

Like other forms of epilepsy, noctural epilepsy can be treated with anti-convulsants.[9] Despite the effectiveness of anti-convulsants in people who suffer from nocturnal epilepsy, anti-convulsants are shown to disrupt a persons sleeping structure.[10] 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.[11] 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.[12] 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.[13] [14]

References[edit]

  1. ^ http://www.drugs.com/dict/nocturnal-epilepsy.html
  2. ^ [Paul R. C, Richard B. B, James D. G]. Clinical sleep disorders. Philadelphia : Lippincott Williams & Wilkins, 2005. Scholars Portal Books
  3. ^ http://books.google.com/books?id=KUhpAAAAIAAJ&pg=PA311&dq=%22nocturnal+epilepsy%22&lr=&ie=ISO-8859-1&output=html
  4. ^ http://books.google.com/books?id=Rm3N4EBKwOwC&pg=PA221&dq=%22nocturnal+epilepsy%22&lr=&ie=ISO-8859-1&output=html
  5. ^ http://books.google.com/books?id=5moBAAAAYAAJ&pg=PA409&dq=%22nocturnal+epilepsy%22&lr=&ie=ISO-8859-1&output=html
  6. ^ [Paul R. C, Richard B. B, James D. G]. Clinical sleep disorders. Philadelphia : Lippincott Williams & Wilkins, 2005. Scholars Portal Books
  7. ^ [Paul R. C, Richard B. B, James D. G]. Clinical sleep disorders. Philadelphia : Lippincott Williams & Wilkins, 2005. Scholars Portal Books
  8. ^ [Paul R. C, Richard B. B, James D. G]. Clinical sleep disorders. Philadelphia : Lippincott Williams & Wilkins, 2005. Scholars Portal Books
  9. ^ http://books.google.com/books?id=gLOv8XZ5u48C&pg=PA51&lpg=PA51&dq=%22nocturnal+epilepsy%22&source=bl&ots=OMJzRtKNQt&sig=YYLuys9_pxnoANJfpZPgzUfsFwA&hl=en&ei=qgCTSZrlJY_ftgfa2qjdCw&sa=X&oi=book_result&resnum=2&ct=result
  10. ^ [Thorpy, Michael J., Plazzi, Giuseppe]. The Parasomnias and Other Sleep-Related Movement Disorders. Cambridge University Press, 2010. Cambridge Books Online. http://dx.doi.org.myaccess.library.utoronto.ca/10.1017/CBO9780511711947.032
  11. ^ [Paul R. C, Richard B. B, James D. G]. Clinical sleep disorders. Philadelphia : Lippincott Williams & Wilkins, 2005. Scholars Portal Books
  12. ^ [Paul R. C, Richard B. B, James D. G]. Clinical sleep disorders. Philadelphia : Lippincott Williams & Wilkins, 2005. Scholars Portal Books
  13. ^ [Paul R. C, Richard B. B, James D. G]. Clinical sleep disorders. Philadelphia : Lippincott Williams & Wilkins, 2005. Scholars Portal Books
  14. ^ [Thorpy, Michael J., Plazzi, Giuseppe]. The Parasomnias and Other Sleep-Related Movement Disorders. Cambridge University Press, 2010. Cambridge Books Online. http://dx.doi.org.myaccess.library.utoronto.ca/10.1017/CBO9780511711947.032