Nocturnal epilepsy is a chronic neurological disease that occurs during sleep. Causes, symptoms and treatments with Dr. Marc Rey, sleep neurologist, president of the National Institute of Sleep and Vigilance (INSV).
Definition: what is nocturnal epilepsy?
Epilepsy is a neurological disease characterized by the onset of epileptic seizures. There are two types of epilepsies: epilepsies partial or focal, which concern only one part of the body, and which originate in a localized part of the brain; and the generalized epilepsies, which cause shocks throughout the brain and affect the whole body. “As indicated by his name, nocturnal epilepsy occurs at night. A special form of nocturnal epilepsy is called dystonia paroxysmal nocturnal. It results in seizures that occur during sleep or during nocturnal waking phases. This is a particular form of so-called frontal epilepsy, that is to say, which affects the anterior part of the brain“, says Dr. Marc Rey.
What causes nocturnal epilepsy in babies?
In babies under two years of age, nocturnal epilepsy can be difficult to spot. It can be manifested by tremors of an arm or a leg, eye movements or, on the contrary, gaze fixed on one side. In toddlers, the most common cause of nocturnal epilepsy is fever (convulsion febrile).
What causes nocturnal epilepsy in adults?
Like all forms of epilepsy, nocturnal epilepsy is linked to a abnormal electrical activity of the brain. There are causes genetics and lesional causes (next to a trauma, to a Cerebrovascular Accident or in the evolution of brain tumours). The meningitis and theencephalitiswhich are diseases of the nervous system, can also be responsible for epileptic seizures. “There are no specific causes explaining nocturnal epilepsy. There is sometimes a family factor but it is not systematic. Sleep is an activator epilepsy because the electrical activity of the brain changes when falling asleep, which can promote seizures“, specifies the neurologist.
What are the symptoms of nocturnal epilepsy?
“There are many forms of epilepsy and thousands of different manifestations. What the general public knows is the generalized form of tonic-clonic epileptic seizure in which the subject falls to the ground, shakes and drools. Symptoms depend on the area of the brain involved in the seizure. For example, in occipital epilepsy, which starts from the region of vision, we have a kind of flying fly in front of eyes or some hallucinations visual more complex“, develops the specialist. In frontal epilepsy, located in the frontal lobe, the area of the brain that controls language, motor skills and behaviors, the symptoms are very varied as localized uncontrolled muscle twitching in one place of the body, language disorders.
The recording allows the differential diagnosis between somnambulism and epilepsy
The diagnosis is based on a questioning and an electroencephalogram (EEG) which makes it possible to record inter-critical elements, that is to say abnormal cerebral electrical activities, over short periods of time. “Very often, it will be necessary to record at night. 22 electrodes will be positioned on the subject’s head. A video shows what happens when there is abnormal electrical activity in the brain: does the subject move, get up, what does it do. In adults, when there is somnambulism, the recording allows the differential diagnosis between somnambulism and epilepsy. The diagnosis of nocturnal epilepsy is more difficult because it is a more unusual form“, details our interlocutor.
How to treat nocturnal epilepsy?
The treatment of nocturnal epilepsy is common to all epilepsies. It relies on taking a antiepileptic which aims to regulate electrical activity one or more areas of the brain. The choice of drug depends on the type of epilepsy.
Thanks to Dr. Marc Rey, sleep neurologist, president of the National Institute of Sleep and Vigilance (INSV)