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Nonepileptic seizures during apparent sleep

K Thacker1, O Devinsky, K Perrine

  • 1Department of Neurology, New York University School of Medicine, Hospital for Joint Diseases, NY 10003.

Annals of Neurology
|April 1, 1993
PubMed
Summary
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Nonepileptic seizures (NESs) can occur during apparent sleep, presenting with a distinct alpha rhythm. Video-EEG monitoring confirmed these episodes are not true epileptic seizures, even when patients report them happening during sleep.

Area of Science:

  • Neurology
  • Clinical Neurophysiology

Background:

  • Nonepileptic seizures (NESs) are often challenging to diagnose.
  • Distinguishing NESs from epileptic seizures, particularly during sleep, requires careful evaluation.

Purpose of the Study:

  • To investigate the occurrence and characteristics of nonepileptic seizures presenting during apparent sleep.
  • To evaluate the utility of video-electroencephalographic (video-EEG) monitoring in diagnosing NESs during sleep.

Main Methods:

  • Retrospective analysis of 12 patients with NESs documented during apparent sleep via video-EEG monitoring.
  • Clinical observation and provocative testing with suggestion were employed.

Main Results:

  • All 12 patients exhibited a posterior alpha rhythm before seizure onset despite appearing asleep.

Related Experiment Videos

  • Episodes were clinically consistent with NESs and lacked typical ictal/postictal EEG changes.
  • Provocative testing confirmed the non-epileptic nature in 9 patients.

    • Conclusions:

    • Nonepileptic seizures occurring during apparent sleep are a recognized phenomenon.
    • Video-EEG monitoring is crucial for accurate diagnosis of NESs in sleep-like states.
    • The presence of a pre-episode alpha rhythm may be a characteristic feature of NESs during sleep.