Sleep attacks mimicking epileptic seizures and pseudoseizures

• Published in: Journal of epilepsy 1997-09, Vol.10 (5), p.232-235
• Main Authors: Malow, Beth A., Fromes, Gail A., Selwa, Linda M.
• Format: Article
• Language: English
• Subjects: Obstructive slep apnea; Periodic limb movements; Pseudoseizures; Seizures; Sleep disorders
• ISSN: 0896-6974
• DOI: 10.1016/S0896-6974(97)00057-1

Common treatable sleep disorders resulting in excessive daytime sleepiness may resemble or contribute to spells of altered responsiveness. These spells may mimic epileptic seizures or other paroxysmal disorders. Three patients presented with paroxysmal spells of altered responsiveness that were attributed initially to epileptic seizures or pseudoseizures. One patient had a history of childhood epilepsy and was referred for the concern of recurrent seizures. In another patient, antiepileptic drugs (AEDS) were prescribed for suspected epileptic seizures without an improvement in spells. After their physicians obtained a history of excessive daytime sleepiness, snoring, and/or restless leg symptoms, patients were evaluated with polysomnography, multiple sleep latency tests, electroencephalograms (EEG), and video-EEG monitoring. Sleep studies were diagnostic of obstructive sleep apnea, periodic limb movement disorder, and probable narcolepsy. In all patients, spells of altered responsiveness and excessive daytime sleepiness improved or resolved with treatment of the sleep disorder or discontinuation of AEDS. Patients presenting with paroxysmal spells of altered responsiveness and excessive daytime sleepiness should be evaluated for sleep disorders. Identification and treatment of an underlying sleep disorder may contribute to resolution of their spells.