Sleep seizures: Clinical, electrophysiological and radiological study

Objective: to determine the frequency and characteristics of (sleep seizures) SS among our epileptic patients. Methods: hospital-based study, comparing 58 patients with SS (11.1%) to 466 patients with wake seizures (WS) (88.9%) regarding clinical, EEG characteristics, and brain imaging findings. Results: No differences in demographic data between WS and SS patients, partial seizures and complex partial seizure subtype were more common among patients with WS while generalized seizures were more frequent among SS patients. Sleep deprived EEG showed higher frequency of focal discharges among WS patients while focal secondarily generalized discharges were more common in SS patients. Brain imaging studies showed higher frequency of left sided lesions, and frontal lobe lesions among patients with SS. Conclusion: The proportion of epilepsies with SS is low and their diagnosis is difficult. Good history taking and overnight sleep video-EEG recording are important to diagnose them. It is likely that dominant side and frontal lobe involvement is associated with higher number seizures during sleep.