A 37-Year-Old Man With Structural Focal Epilepsy and Paroxysmal Nocturnal Breathing Arrests

A 37-year-old male patient was referred to our sleep laboratory with suspected sleep-disordered breathing. His partner reported periods of breathing arrest accompanied by an odd expiratory noise during sleep, occurring on a near to weekly basis. The patient stated that he was able to sleep well, did not have excessive daytime sleepiness, and was not subjectively aware of any disordered breathing at night. He had a history of structural epilepsy following perinatal trauma, with secondary generalized tonic/clonic seizures, preceded by sensory oral misperceptions. The patient was medicated with phenytoin (100 mg), and reported being seizure-free within the last year. He said that he was otherwise in good health.