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Epilepsy and sleep-disordered breathing as false friends: a case report

Ottavio Vitelli1, Silvia Miano1, Alessandra Tabarrini1

  • 1Faculty of Medicine and Psychology, Neuroscience, Mental Health and Sense Organs Department, Chair of Pediatrics, Sleep Disorder Centre, "La Sapienza" University, Rome, Italy.

Journal of Child Neurology
|November 22, 2013
PubMed

Insights

Distinguishing nocturnal seizures from sleep apnea is challenging due to overlapping symptoms. This case highlights a child misdiagnosed with obstructive sleep apnea who actually experienced seizures with EEG activity.

Area of Science:

  • Neurology
  • Sleep Medicine
  • Pediatrics

Background:

  • Nocturnal seizures and sleep respiratory events share overlapping clinical signs, complicating diagnosis.
  • Differentiating between epileptic seizures and sleep disorders is crucial for appropriate patient management.

Observation:

  • A 3-year-old child presented with symptoms mimicking severe obstructive sleep apnea.
  • The child exhibited ictal electroencephalographic (EEG) activity, paradoxical breathing, desaturations, and tonic-dystonic posture with movement artifacts.

Findings:

  • The patient's presentation was initially misdiagnosed as severe obstructive sleep apnea syndrome after cardiorespiratory polysomnography.
  • The core issue was atypical obstructive sleep apnea associated with seizure activity.

Implications:

  • This case underscores the importance of considering epileptic seizures in the differential diagnosis of pediatric sleep-disordered breathing.
  • Accurate diagnosis requires careful evaluation of EEG alongside polysomnography to differentiate seizure-related events from primary sleep disorders.
  • Improved diagnostic criteria are needed to distinguish between nocturnal seizures and sleep respiratory events in children.

Keywords:
cardiorespiratory monitoringchildrenobstructive sleep apneapolysomnographyseizures

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