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Seizures and arousals from sleep--which comes first?
Sleep
|November 1, 1995
Summary
Seizures and sleep arousals can be difficult to distinguish using surface EEG. Intracranial EEG revealed that the seizure actually began before the arousal, highlighting limitations of surface recordings.
Area of Science:
- Neurology
- Sleep Medicine
- Epileptology
Background:
- Epileptic seizures are sometimes linked to sleep arousals.
- Determining the temporal relationship between seizures and arousals is challenging with surface electroencephalogram (EEG) alone.
Observation:
- A patient with medically refractory partial epilepsy showed seizure onset seemingly after arousal from stage 2 non-rapid eye movement sleep on surface EEG.
- Simultaneous intracranial EEG recordings were obtained for this patient.
Findings:
- Intracranial EEG demonstrated that the epileptic seizure onset preceded the observed arousal.
- This contradicts the initial interpretation based on surface EEG.
Implications:
- Surface EEG has limitations in accurately determining the temporal sequence of seizures and arousals.
- Intracranial electrode recordings are valuable for precise investigation of seizure-arousal relationships.