Nocturnal epilepsy

Nocturnal epilepsy is a disorder in which the patient experiences symptoms of seizures at night, usually while sleeping. Several common forms of epilepsy, including frontal lobe epilepsy, can manifest in a nocturnal state. Nocturnal Frontal Lobe Epilepsy is a distinct paroxysmal sleep-related disorder covering a spectrum of presentations of presumed frontal lobe origin.

These seizures are usually tonic-clonic seizures, where the patient may fall into a deep sleep or lose consciousness immediately after their seizure.

Symptoms:

The seizures might occur just after a person has fallen asleep, just before waking, during daytime sleep, or while in a state of drowsiness.
People who experience nocturnal seizures may find it difficult to wake up or to stay awake.
After getting up from the sleep they may arise with a headache, have temper tantrums, or other destructive behavior throughout the day.
There may be some unusual differences such as having wet the bed, having bit the tongue, a bone or joint injury or light-headedness.
Diagnosis:

Electroencephalogram test or scalp EEG is the premiere test given in order to diagnose epilepsy. Other techniques used to differential diagnose nocturnal epilepsy include MRI (Magnetic Resonance Imaging) of the brain, PET (Positron Emission Tomography), SPECT (Single-Photon Emission Computed Tomography) and MRS (Magnetic resonance spectroscopy).

Treatment:

Anticonvulsant therapy should be initiated once the diagnosis of epilepsy is established. Many nocturnal episodes of epilepsies are treated well carbamazepine.

Patients with medically intractable nocturnal epilepsy are considered for resective epilepsy surgery. In this surgery, the surgeon removes the area of the brain that causes the patient’s seizures. Here it is the temporal lobectomy, in which part of the temporal lobe of the brain is removed.

If resective surgery is not possible, other surgical options include corpus callosotomy, multiple subpial transections, or the vagal nerve stimulator.