Nocturnal seizures are difficult to distinguish from parasomnias. They might occur just after a person has fallen asleep, just before waking, during daytime sleep, or while in a state of drowsiness. People who experience nocturnal seizures may find it difficult to wake up or to stay awake. Although unaware of having had a seizure while asleep, they may arise with a headache, have temper tantrums, or other destructive behavior throughout the day.
Nocturnal seizures and their mechanisms are poorly understood. The majority of people with nocturnal seizures have idiopathic epilepsy and there is evidence that sleep enhances epileptic discharges in the EEG, though their daytime recordings may appear to be normal. Any repetitive, stereotyped behavior during sleep could be a seizure and should be investigated with an overnight sleep study with extended EEG monitoring.
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