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Sleep-related epilepsy syndromes

Author
Erik K St Louis, MD, MS
Section Editors
Alon Y Avidan, MD, MPH
Paul Garcia, MD
Deputy Editor
April F Eichler, MD, MPH

INTRODUCTION

Epileptic seizures frequently manifest during the sleep state and are often difficult to distinguish from parasomnias and other nonepileptic events, particularly when seizures occur exclusively during sleep. While most epilepsies have a diurnal component (ie, seizures may occur during both sleep and wake), several epilepsy syndromes have an especially intimate and robust relationship with sleep.

This topic reviews the pathophysiology of seizures and epilepsy related to sleep and the clinical features, diagnosis, and treatment of common sleep-related epilepsy syndromes. The clinical features, diagnosis, and treatment of seizures and epilepsy more generally are reviewed elsewhere. (See "Evaluation and management of the first seizure in adults" and "Overview of the management of epilepsy in adults" and "Clinical and laboratory diagnosis of seizures in infants and children" and "Seizures and epilepsy in children: Classification, etiology, and clinical features" and "Seizures and epilepsy in children: Initial treatment and monitoring".)

EPIDEMIOLOGY AND CLASSIFICATION

Although the International League Against Epilepsy does not formally classify sleep-related epilepsies, in practice they can be divided into three major categories:

Pure sleep epilepsies, in which seizures occur exclusively or predominantly during sleep (eg, benign epilepsy of childhood with centrotemporal spikes, nocturnal frontal lobe epilepsy) (see 'Benign focal epilepsies of childhood' below and 'Nocturnal (sleep-related) focal epilepsies' below)

Sleep-accentuated epilepsies, in which seizures occur during both wakefulness and sleep but epileptiform activity is potentiated during sleep (eg, certain epileptic encephalopathies, including Lennox-Gastaut syndrome and Landau-Kleffner syndrome) (see 'Sleep-accentuated epilepsies' below)

                      

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Literature review current through: Jul 2017. | This topic last updated: Mar 24, 2017.
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