Overview:

As the seizures are nocturnal, it has been suggested that they are connected to sleep apnea or another sleep related disorder, or that they have a connection to melatonin, or that there is some connection to circadian rhythms.

Background:

We received a suggestion on the FB page from an RN who experienced adult onset seizures. Her physicians felt sleep apnea could be playing a role in her condition, and she is on CPAP at night. She suggested testing for sleep apnea.

A contributor posting on Science Roll suggested a sleep lab study with complete monitoring during these episodes, noting that it would be valuable to monitor her as completely as possible, including blood draws. He suggested that a lab might have the ability to perform fMRI while she is having seizures. Additionally, he recommended the rerults be read blind: "I recall a case at St. Vincent’s in NYC where a neurologist came into the nuclear medicine lab, spotted an image on the screen, and declared, “Epilepsy.” No, the nuclear medicine special said, schizophrenia. “No, that’s epilepsy,” the neuro responded. The patient was given a therapeutic trial of an antiepileptic agent, and the “schizophrenia” resolved. Occasionally, knowledge of the patient’s history sends clinicians down the wrong path. My sense is, the diagnostic process begins with understanding physiologically and neurologically what’s going on when she’s having those seizures."


From our review of the literature, there is a known association between adult onset epilepsy and sleep apnea.

Follow Up:

We had a visit scheduled with the UCSF sleep clinic. After describing the nighttime pattern of seizures and that they came and went in clusters, the director did not believe that this was a case of sleep apnea. He said that they would not come and go but would occur on a more regular schedule.

Questions:

Could a sleep disorder, perhaps in combination with the other underlying conditions, trigger clusters of seizures with the timing/periodicity observed?

Action Plan:

At present, a sleep study is not part of the plan. This may be revisited.

Have something to tell us? Send an email to seizuremystery@gmail.com or contact us on Facebook.

Have any suggestions about this wiki? Take our survey.