Nocturnal Epilepsy

Your brain's cells communicate by transmitting electrical impulses to other areas of your body, including muscles, nerves, and other regions of your brain. Sometimes, when these become faulty, the signals may be too many or few, which may result in a seizure.

Seizures are associated with any form of epilepsy, which can even occur during sleep. Epilepsy is the most prevalent cause of seizures. Epilepsy is confirmed when you have two or more unprovoked seizures at least 24 hours apart that are not caused by another medical condition. Epilepsy is most commonly diagnosed in children under the age of 10 and adults over the age of 55.

There are many different kinds of seizures in epilepsy, which can be broadly categorized as generalized seizures and focal, or partial, seizures. Seizures that occur while sleeping are associated with night-time seizures, which commonly start in childhood. Approximately 70 to 80 percent of seizures in children with benign rolandic epilepsy occur when they are asleep.

Types:

Nighttime seizures are linked to the following types of epilepsy:

1. Juvenile myoclonic epilepsy
2. Tonic-clonic seizures upon waking
3. Benign rolandic also known as benign epilepsy of childhood with central temporal spikes.
4. Electrical status epilepticus of sleep
5. Landau-Kleffner syndrome
6. Frontal lobe onset seizures

According to researchers, two-thirds of seizures occur between 8 p.m. and 8 a.m.

Symptoms:

It can be difficult for parents or caretakers to recognize nocturnal seizures, especially in children, but symptoms may include:

1. Crying out loud
2. Unusual noises during sleep
3. Convulsions
4. Bedwetting in toilet-trained children
5. Muscle twitches or sudden jerks of the extremities
6. Biting tongue during sleep
7. Falling out of bed
8. Suddenly waking
9. Strange movements or postures while sleeping

Diagnosis:

Sleep seizures can be easily confused with parasomnia, an umbrella term for a group of sleep disorders, and hence can be difficult to diagnose. Sleep disorders include:

1. Sleepwalking
2. Teeth grinding
3. Restless legs syndrome

To determine and differentiate between epilepsy and sleep disorders and to confirm the diagnosis of epilepsy, the doctor needs to take a complete history and select the form and type of seizures. Questions might include: 

1. The type of seizures 
2. The age when the seizures began
3. Family history of epilepsy
4. Other existing medical conditions 

Tests required to diagnose this condition may include:

1. Images of electrical activity in the brain recorded by an EEG
2. The structure of the brain in a CT scan or MRI
3. A record of the seizure activity

Consult a doctor right away if you think your kid or newborn is suffering seizures at night. You can assess your child by:

• Using a baby monitor in their room so they can hear and see if a seizure occurs
• Keep an eye out for symptoms including unusual tiredness, headaches, drooling, vomiting, or bedwetting in the morning
• Using a seizure monitor, which is equipped with sensors for motion, noise, and wetness.

Treatment and Prevention:

Nocturnal epileptic seizures can be dangerous and sometimes fatal. A person may be more prone to self-inflicted injury after having a seizure while they are asleep. It is more common for those who have nocturnal seizures to experience low blood oxygen levels both during and immediately following the seizure. Additionally, they have a higher likelihood of continuing to have abnormal brain activity following the seizure.

The right kind of treatment will depend on first getting the proper diagnosis of the type of epilepsy the person has, the type of seizure, the cause, and any other coexisting medical conditions or conditions that may trigger epileptic seizures. Treatments include:

1. Medications- anti-seizure medication, such as phenytoin helps in avoiding seizure triggers, such as sleep deprivation
2. Diet: Researchers have suggested a high-fat, low-carbohydrate diet or ketogenic diet for people diagnosed with epilepsy.
3. Surgery: a vagus nerve stimulator or surgical implant that sends electrical impulses to the brain and stops the signals causing epilepsy
4. Preventive measures like choosing a low bed frame or placing the mattress on the floor, putting a safety mat, such as those for gymnastics, on the floor next to the bed, using wall-mounted lamps rather than table lamps, keeping furniture away from the bed and using a nocturnal seizure monitor that alerts a loved one when a person has a seizure.

Conclusion:

Nighttime seizures, or nocturnal seizures, usually occur in particular forms of epilepsy. It is most common in children, and noticing the symptoms and lack of certainty is the drawback of this kind of epilepsy as it can be masked or confused with sleep disorders. Proper monitoring and assessment by the parent or caregiver are important, and if epilepsy is doubted, you should immediately consult the doctor. Most kinds of epilepsy are usually treatable. With the right kind of medicines and treatment modalities, nocturnal seizures can be avoided.