Understanding Nighttime Seizures: Causes, Symptoms, and Diagnosis

Nighttime seizures, also called nocturnal seizures, happen during sleep and can be as dangerous as seizures during wakefulness. They vary in type and severity, affecting individuals differently. If left untreated, they can pose serious health risks. This article covers key aspects of nighttime seizures, including their causes, symptoms, and how they are diagnosed.

What leads to nighttime seizures?
While the exact cause remains uncertain, irregular electrical activity in the brain during sleep is believed to be a major factor.

The following common risk factors can increase the likelihood of experiencing sleep-related seizure signs:

Epilepsy
The most frequent cause is epilepsy, a neurological disorder characterized by abnormal brain electrical activity. Those with epilepsy may have seizures whether awake or asleep.

Other health conditions
Brain tumors, infections, head trauma, strokes, and metabolic issues can also trigger sleep seizures.

Genetic factors
Genetic mutations can heighten the risk of specific sleep seizures or strokes during sleep.

Sleep disorders
Conditions like sleep apnea and narcolepsy can increase seizure chances during sleep.

Medication side effects
Some treatments list seizures as possible adverse effects.

Severe health issues, such as tumors or infections, may also cause sleep seizures. Consulting a healthcare professional is essential. Diagnostic tests help identify seizure types and inform treatment plans.

What are common sleep seizure symptoms? Seizure symptoms during sleep depend on the seizure type—focal, generalized, or tonic-clonic—and their severity. These symptoms resemble those experienced during awake seizures and include:

Unusual movements
Jerking or twitching of limbs, sometimes violent when near furniture. Some individuals wake up and move around during a seizure.

Breathing irregularities
Erratic breathing or pauses during seizures. For those with sleep-related breathing disorders, snoring or gasp episodes can be dangerous.

Mental confusion
Post-seizure confusion, difficulty understanding, or memory lapses are common.

Incontinence
Loss of bladder or bowel control, which can be distressing in social settings.

Sleep disturbances
Seizures can disrupt sleep, leading to daytime fatigue, sluggishness, and increased risks during activities like driving.

Unusual sounds
Strange noises such as grunting or moaning may occur during seizures, affecting those nearby.

In children, symptoms often appear in early morning, with movements and unusual sleeping positions. Adults may experience similar symptoms but are less prone to sleepwalking or bedwetting.

Diagnosis of sleep seizures
Since nighttime seizures occur during sleep, diagnosis can be challenging. Tests include:

EEG
Records brain activity via scalp electrodes, revealing abnormal patterns during sleep seizures.

Video-EEG
Combines EEG with video recording to correlate actions with brain activity, aiding seizure identification.

Sleep study
A comprehensive sleep test monitors brain waves, eye movements, heart rate, and breathing to identify related issues.

Physical exam and history
Medical history and examination help rule out other causes and confirm diagnosis.

Accurate diagnosis and appropriate treatment depend on consultation with a neurologist or healthcare professional.