Epilepsy attacks during sleep in children. Signs of various forms of epilepsy in children

Epilepsy is a brain pathology in which seizures recur periodically and begin suddenly. This condition negatively affects many important processes in the body and makes the quality of life much worse, creating many problems for the patient. Every hundredth person on earth suffers from this disease, and it is one of the most common. Unpredictable attacks can strike a person at any time of the day or night.

Characteristic

Epilepsy attacks often occur at night. A seizure during sleep activates a group of neurons that are located in the focus of excitation, which provokes seizures. This condition occurs much more mildly during sleep than at other times of the day.

If epilepsy is in a generalized form, then convulsions occur at the moment of awakening and are characterized by trembling of some muscles. In some cases they twitch facial muscles, involuntary squinting of the eyes occurs, limbs twitch. It's actually hard to describe the attacks. nocturnal epilepsy, since everyone experiences them differently.

This syndrome very often worries people from 7 to 40 years old. There are cases when epilepsy goes away on its own during sleep. This may occur due to changes nervous system with age. The person gets older, the system improves, and the seizures go away.

If epilepsy attacks were noticed during sleep, then experts note that the focus is localized in frontal parts brain This pathology is called frontal lobe epilepsy.

Most often it has a hereditary basis and is initially noticed in adolescence. Such attacks can be very frequent and occur against a background of stress, nervous overstrain, experiences or consumption of alcoholic beverages.

Nocturnal epilepsy in children

Very often, nocturnal epilepsy in children occurs due to brain injury. Most often, this pathology develops after a birth injury, the appearance of an infection that affects the brain, or a head injury. In some cases, this disease manifests itself as genetic. That is, a child inherits epilepsy from his parents or close relatives.

A child may experience nocturnal seizures and convulsions due to sleep disturbances, stress, or completely without visible reasons, as an age-related manifestation. Parents do not always immediately notice this pathology, since all signs of the disease appear at night, when everyone is sleeping. Therefore some children long time do not have supervision during attacks.

Forms of parasomnia attacks

Night attacks are divided into the following types:

• Parasomnias. In this case, an involuntary shudder occurs lower limbs. Upon awakening, their temporary immobility is noticed.
• Sleepwalking. This type of parasomnia occurs mainly in childhood and ends with growing up. In this case, the child suffers from nightmares and urinary incontinence. If sleepwalking does not go away with age, then a person in this state can cause bodily injury to himself and exhibit aggressive behavior while waking up. After a person wakes up, he does not remember what happened to him. The brain cannot control such a manifestation as urinary incontinence. When filling bladder automatically empties, but the child does not understand that he wants to go to the toilet and does not have time to wake up. This syndrome most often occurs in boys under 14 years of age.

Types of manifestation

Nocturnal epilepsy has the following forms:

1. Frontal.
2. Temporal.
3. Occipital.

But if we consider the disease in general, then this form of epilepsy is considered quite mild and has a favorable prognosis and is easily treatable.

Autosomal dominant nocturnal frontal epilepsy appears around the age of 7-12 years and is a manifestation of a gene defect. This pathology is characterized by frequent awakenings, dystonia, seizures. All this can happen several times a night.

Epilepsy with centrotemporal spikes is most common in children, most often manifesting between the ages of 5 and 12 years. In this case, problems with swallowing, convulsions, paresthesia, speech problems, increased salivation. The person is conscious at this time. This type of epilepsy is very often simply related to the age of the child. Symptoms appear in the first stage of sleep and before awakening. In most cases, the disease resolves on its own with adulthood.

Electrical sleep status epilepticus is an encephalopathy, which is also an age-related pathology. It manifests itself in delta sleep in the form of attacks. The disease manifests itself from 2 months to 12 years and can negatively affect the development of psychomotor skills.

The following also develops against the background of the disease:

• aggressive behavior;
• short-term muteness, talking, incoherent speech;
• lag in development, mental retardation;
• syndrome that develops from a lack attention;
• strong excitation, nervousness.

Landau-Kleffner acquired aphasia syndrome. This type of nocturnal epilepsy occurs between the ages of 2 and 8 years. This pathology manifests itself in the non-REM sleep phase. The child wakes up for no reason during the attacks.

Idiopathic generalized epilepsy is noticed between the ages of 2 and 10 years. Basically, the disease is activated immediately after waking up. During an attack, the shoulders and arms twitch, and unconsciousness, sleep problems.

When do seizures most often occur?

Sleep has several stages. Most of the seizures occur at the moment of falling asleep, that is, in the light phase of sleep. Attacks also occur during awakenings in the middle of the night and in the morning.

Despite the fact that the pathology has not been fully studied, experts note that it is the brain and its activity that is directly related to seizures. It is believed that during sleep there is a large amount of various changes and seizures occur at specific times of sleep and wakefulness.

Cramps can become active at any time, but they were mainly noticed during the first and second stages of sleep. That is, most often seizures can appear:

• In the 1st or 2nd hour after falling asleep.
• If awakening happened 1-2 hours earlier than expected.
• In the morning within 1.5 hours after the person wakes up.

Cramps may also occur after a nap.

Causes

Since epilepsy has not been fully studied by specialists, the exact cause of its origin is difficult to voice. But there are suggestions that can provoke pathology:

• Hypoxia or oxygen starvation.
• Ancestral injury.
• Neoplasms in the area of ​​the brain.
• Inflammatory process in the brain area.
• Pathological intrauterine development.
• Infections.
• Injury brain.

Patients with nocturnal epilepsy are advised to control their sleep time and not reduce it. Otherwise, it will provoke more frequent attacks. Such people are not recommended to work at night. Also, the causes of seizures include a very loud sound of an alarm clock and a change in time zones.

Symptoms

The main symptom of nocturnal epilepsy is seizures that occur only during sleep and awakening. Also, epilepsy during sleep can manifest itself as follows:

• nausea and bouts of vomiting;
• convulsions;
• shiver;
• conversations in a dream;
• sleepwalking;
• Problems with sleep;
• nightmares;
• voltage all muscles;
• involuntary urination;
• frequent awakening, having no reason;
• dysarthria.

In some cases, distortion of the face and eyes is noticed. The patient may move involuntarily in his sleep, get on all fours, and make other movements. The attacks do not take long and can last about 10 seconds.

How to stay safe

It has been established that improper sleep, its restriction or lack of sleep can lead to consequences in the form of night attacks. Therefore, it is necessary to create all conditions for a patient with nocturnal epilepsy:

1. The best bed to choose low with a back trimmed with soft material. Two-tier and ra
2. Composite structures are not recommended.
3. It is not advisable to sleep on large and very soft pillows, which may cause suffocation.
4. It is best to place the bed away from different furniture, this will help prevent injury.
5. You can place it near your sleeping area mats or other protective structures, mats that will be relevant in case of a fall.
6. Lamps It is best to use wall lamps, and table lamps should be excluded.
7. Rough carpets It is best to remove it from the bed, otherwise rubbing against it may cause injuries to the skin.

By following safety rules, you can exclude unpleasant consequences seizures and convulsions.

Diagnostics

Diagnosis is initially carried out by familiarizing yourself with the complaints and external examination of the patient. Also held instrumental diagnostics– electroencephalography.

Electroencephalography (EEG) is one of the main methods that helps identify nocturnal epilepsy. This diagnostic method helps to detect high-amplitude peaks and waves that provoke convulsions and seizures.

Since the symptoms of the disease manifest themselves mainly at night, in addition to the daytime EEG diagnosis, a night EEG is also performed. They also suggest going through:

• video monitoring;
• teleencephalographic monitoring.

Also carry out differential diagnosis which will help exclude other pathologies.

Therapy

Nocturnal epilepsy is one of the most simple forms The disease and treatment are not particularly complex. But if the patient does not want to take special medications prescribed by the doctor, then, most likely, attacks will begin to appear during the daytime and the disease will develop into a more complex form.

Antiepileptic drugs are mainly prescribed, where the dosage is calculated for each patient individually, calculating the frequency of attacks and the duration of their duration.

During therapy, you must follow some rules:

• If you experience drowsiness during the day after taking medications and insomnia at night, you should definitely contact doctor and tell him about it. Most likely, the drug will be changed to another
• It is advisable to sleep go to bed at the same time and do not violate this schedule. The patient should get enough sleep to avoid daytime manifestations of the disease.
• Prohibited to accept caffeine and sedative medications - this can negatively affect the entire treatment and interfere with positive results.

It is also worth taking care of safety rules.

Prevention

Prevention of nocturnal epilepsy is as follows:

• Correct nutrition.
• Active Lifestyle.
• Evocation alcohol.
• Walks in the fresh air.
• Exception stress, nervous overstrain, depression.
• Refusal of night duty, 24/7 work.

And most importantly, we need to establish as much as possible night sleep and make sure that the person gets enough sleep. To do this, you can ventilate the room, choose the right bedding, mattress and pillow, do not wear uncomfortable night clothes, do not overeat before bed, and drink a glass of warm milk.

Consequences and complications

If you start treating the disease in time and protect your sleeping place, then complications and consequences can be avoided. But you should know that the disease is dangerous:

• injuries;
• chronic lack of sleep;
• day lethargy and drowsiness;
• attacks at other times of the day;
• night nightmares;
• oxygen fasting;
• pain in muscles as a consequence of cramps;
• bad well-being;
• reduction immunity.

Despite the fact that the disease does not have a high risk of development, it should not be left completely unattended. We must pass full diagnostics, improve your lifestyle and follow your doctor’s recommendations.

Epilepsy is a brain pathology in which seizures recur periodically and begin suddenly. This condition negatively affects many important processes in the body and makes the quality of life much worse, creating many problems for the patient. Every hundredth person on earth suffers from this disease, and it is one of the most common. Unpredictable attacks can strike a person at any time of the day or night.

Characteristic

Epilepsy attacks often occur at night. A seizure during sleep activates a group of neurons that are located in the focus of excitation, which provokes seizures. This condition occurs much more mildly during sleep than at other times of the day.

If epilepsy is in a generalized form, then convulsions occur at the moment of awakening and are characterized by trembling of some muscles. In some cases, facial muscles twitch, involuntary squinting of the eyes occurs, and limbs twitch. In general, it is difficult to describe attacks of nocturnal epilepsy, since everyone experiences them differently.

This syndrome very often worries people from 7 to 40 years old. There are cases when epilepsy goes away on its own during sleep. This can occur due to changes in the nervous system with age. The person gets older, the system improves, and the seizures go away.

If epilepsy attacks have been noticed during sleep, then experts note that the focus is localized in the frontal parts of the brain. This pathology is called frontal lobe epilepsy.

Most often it has a hereditary basis and is initially noticed in adolescence. Such attacks can be very frequent and appear against a background of stress, nervous tension, anxiety or drinking alcoholic beverages.

Nocturnal epilepsy in children

Very often, nocturnal epilepsy in children occurs due to brain injury. Most often, this pathology develops after a birth injury, the appearance of an infection that affects the brain, or a head injury. In some cases, this disease manifests itself as genetic. That is, a child inherits epilepsy from his parents or close relatives.

In a child, nocturnal seizures and convulsions can begin due to sleep disturbances, stress, or for no apparent reason at all, as an age-related manifestation. Parents do not always immediately notice this pathology, since all signs of the disease appear at night, when everyone is sleeping. Therefore, some children are unsupervised for a long time during attacks.

Forms of parasomnia attacks

Night attacks are divided into the following types:

• Parasomnias. In this case, involuntary shuddering of the lower extremities occurs. Upon awakening, their temporary immobility is noticed.
• Sleepwalking. This type of parasomnia occurs mainly in childhood and ends with adulthood. In this case, the child suffers from nightmares and urinary incontinence. If sleepwalking does not go away with age, then a person in this state may cause bodily harm to himself and exhibit aggressive behavior during awakening. After a person wakes up, he does not remember what happened to him. The brain cannot control such a manifestation as urinary incontinence. When full, the bladder empties automatically, but the child does not understand that he wants to go to the toilet and does not have time to wake up. This syndrome most often occurs in boys under 14 years of age.

Types of manifestation

Nocturnal epilepsy has the following forms:

1. Frontal.
2. Temporal.
3. Occipital.

But if we consider the disease in general, then this form of epilepsy is considered quite mild and has a favorable prognosis and is easily treatable.

Autosomal dominant nocturnal frontal epilepsy appears around the age of 7-12 years and is a manifestation of a gene defect. This pathology is characterized by frequent awakenings, dystonia, and convulsions. All this can happen several times a night.

Epilepsy with centrotemporal spikes is most common in children, most often manifesting between the ages of 5 and 12 years. In this case, problems with swallowing, convulsions, paresthesia, speech problems, and increased salivation are noticed. The person is conscious at this time. This type of epilepsy is very often simply related to the age of the child. Symptoms appear in the first stage of sleep and before awakening. In most cases, the disease resolves on its own with adulthood.

Electrical sleep status epilepticus is an encephalopathy, which is also an age-related pathology. It manifests itself in delta sleep in the form of attacks. The disease manifests itself from 2 months to 12 years and can negatively affect the development of psychomotor skills.

The following also develops against the background of the disease:

• aggressive behavior;
• short-term muteness, talking, incoherent speech;
• lag in development, mental retardation;
• syndrome that develops from a lack attention;
• strong excitation, nervousness.

Landau-Kleffner acquired aphasia syndrome. This type of nocturnal epilepsy occurs between the ages of 2 and 8 years. This pathology manifests itself in the non-REM sleep phase. The child wakes up for no reason during the attacks.

Idiopathic generalized epilepsy is noticed between the ages of 2 and 10 years. Basically, the disease is activated immediately after waking up. During an attack, shoulders and arms twitch, unconsciousness and problems with sleep appear.

When do seizures most often occur?

Sleep has several stages. Most of the seizures occur at the moment of falling asleep, that is, in the light phase of sleep. Attacks also occur during awakenings in the middle of the night and in the morning.

Despite the fact that the pathology has not been fully studied, experts note that it is the brain and its activity that is directly related to seizures. It is believed that during sleep there are a large number of different changes and seizures occur at certain times of sleep and wakefulness.

Cramps can become active at any time, but they were mainly noticed during the first and second stages of sleep. That is, most often seizures can appear:

• In the 1st or 2nd hour after falling asleep.
• If awakening happened 1-2 hours earlier than expected.
• In the morning within 1.5 hours after the person wakes up.

Cramps may also occur after a nap.

Causes

Since epilepsy has not been fully studied by specialists, the exact cause of its origin is difficult to voice. But there are suggestions that can provoke pathology:

• Hypoxia or oxygen starvation.
• Ancestral injury.
• Neoplasms in the area of ​​the brain.
• Inflammatory process in the brain area.
• Pathological intrauterine development.
• Infections.
• Injury brain.

Patients with nocturnal epilepsy are advised to control their sleep time and not reduce it. Otherwise, it will provoke more frequent attacks. Such people are not recommended to work at night. Also, the causes of seizures include a very loud sound of an alarm clock and a change in time zones.

Symptoms

The main symptom of nocturnal epilepsy is seizures that occur only during sleep and awakening. Also, epilepsy during sleep can manifest itself as follows:

• nausea and bouts of vomiting;
• convulsions;
• shiver;
• conversations in a dream;
• sleepwalking;
• Problems with sleep;
• nightmares;
• voltage all muscles;
• involuntary urination;
• frequent awakening, having no reason;
• dysarthria.

In some cases, distortion of the face and eyes is noticed. The patient may move involuntarily in his sleep, get on all fours, and make other movements. The attacks do not take long and can last about 10 seconds.

How to stay safe

It has been established that improper sleep, its restriction or lack of sleep can lead to consequences in the form of night attacks. Therefore, it is necessary to create all conditions for a patient with nocturnal epilepsy:

1. The best bed to choose low with a back trimmed with soft material. Two-tier and ra
2. Composite structures are not recommended.
3. It is not advisable to sleep on large and very soft pillows, which may cause suffocation.
4. It is best to place the bed away from different furniture, this will help prevent injury.
5. You can place it near your sleeping area mats or other protective structures, mats that will be relevant in case of a fall.
6. Lamps It is best to use wall lamps, and table lamps should be excluded.
7. Rough carpets It is best to remove it from the bed, otherwise rubbing against it may cause injuries to the skin.

By following safety rules, you can eliminate the unpleasant consequences of seizures and convulsions.

Diagnostics

Diagnosis is initially carried out by familiarizing yourself with the complaints and external examination of the patient. Instrumental diagnostics are also performed - electroencephalography.

Electroencephalography (EEG) is one of the main methods that helps identify nocturnal epilepsy. This diagnostic method helps to detect high-amplitude peaks and waves that provoke convulsions and seizures.

Since the symptoms of the disease manifest themselves mainly at night, in addition to the daytime EEG diagnosis, a night EEG is also performed. They also suggest going through:

• video monitoring;
• teleencephalographic monitoring.

Differential diagnostics are also carried out, which will help exclude other pathologies.

Therapy

Nocturnal epilepsy is one of the simplest forms of the disease and treatment is not particularly difficult. But if the patient does not want to take special medications prescribed by the doctor, then, most likely, attacks will begin to appear during the daytime and the disease will develop into a more complex form.

Antiepileptic drugs are mainly prescribed, where the dosage is calculated for each patient individually, calculating the frequency of attacks and the duration of their duration.

During therapy, you must follow some rules:

• If you experience drowsiness during the day after taking medications and insomnia at night, you should definitely contact doctor and tell him about it. Most likely, the drug will be changed to another
• It is advisable to sleep go to bed at the same time and do not violate this schedule. The patient should get enough sleep to avoid daytime manifestations of the disease.
• Prohibited to accept caffeine and sedative medications - this can negatively affect the entire treatment and interfere with positive results.

It is also worth taking care of safety rules.

Prevention

Prevention of nocturnal epilepsy is as follows:

• Correct nutrition.
• Active Lifestyle.
• Evocation alcohol.
• Walks in the fresh air.
• Exception stress, nervous overstrain, depression.
• Refusal of night duty, 24/7 work.

And most importantly, we need to improve night sleep as much as possible and make sure that the person gets enough sleep. To do this, you can ventilate the room, choose the right bedding, mattress and pillow, do not wear uncomfortable night clothes, do not overeat before bed, and drink a glass of warm milk.

Consequences and complications

If you start treating the disease in time and protect your sleeping place, then complications and consequences can be avoided. But you should know that the disease is dangerous:

• injuries;
• chronic lack of sleep;
• day lethargy and drowsiness;
• attacks at other times of the day;
• night nightmares;
• oxygen fasting;
• pain in muscles as a consequence of cramps;
• bad well-being;
• reduction immunity.

Despite the fact that the disease does not have a high risk of development, it should not be left completely unattended. You need to undergo a full diagnosis, adjust your lifestyle and follow the doctor’s recommendations.

Generalized seizures

Generalized seizures are among the most well-known and dramatic types of epileptic seizures. All epilepsy attacks can be divided into primary generalized and secondary generalized. The onset of a generalized convulsive seizure is often preceded by certain symptoms, called a precursor or prodrome. This is the name for states of aggression, anxiety, general discomfort, irritability and headaches. The appearance of precursors may occur several days and hours before the onset of a generalized convulsive attack, but they may be absent.

A secondary generalized seizure occurs after the onset of the so-called aura, which includes a whole range of symptoms. These include: a feeling of discomfort in the area gastrointestinal tract, a feeling of detachment from everything that is happening and its unreality, auditory and visual hallucinations, perception of non-existent odors, usually unpleasant. The patient remembers the aura of the attack after he comes to his senses, when the attack is already over, since the aura is part of the attack itself. Usually this is a fairly short period of time, often no more than a few seconds, but for the patient it has great value. During this time, many manage to protect themselves by calling for help, stopping the car, or sitting on the floor. Doctors who specialize in diagnosing and treating the consequences of epilepsy attacks, based on the stereotypicality of the aura and its repeatability from one attack to another, are able in certain cases to accurately determine the location of the source of the disease.

In the case of primary generalized convulsive seizures, the aura may be completely absent; such attacks are extremely dangerous due to their suddenness. Most often, such epileptic seizures occur immediately after waking up in the morning; seizures often occur directly in sleep. The onset of an attack is usually preceded by a loud cry, after which all the muscles of the body are tense, the lips are clenched, the teeth are clenched, and the tongue is often bitten. Breathing may stop completely for some time, after which cyanosis of the skin appears, the so-called cyanosis. After this, rhythmic convulsive twitching of the body and all limbs is observed. As a rule, the attack lasts from one to five minutes, after which it stops just as suddenly. When an epileptic attack occurs, it is extremely important to be able to provide first aid to the patient. A doctor who specializes in the treatment of epilepsy may prescribe treatment using anticonvulsants, which are good for treating seizures, which can achieve complete remission of seizures. In order to assign adequate treatment, it is important to wisely use all the information obtained from sleep monitoring using EEG. Recording is carried out within ten minutes after the patient awakens, this applies to all cases, especially if there is a suspicion of generalized idiopathic epilepsy. It is during this period after the end of the patient’s sleep that an increase in epileptiform activity can be observed.

Seizure causes

A seizure is a storm of electrical impulses in the brain, which occurs as a result of the passage of pathological impulses through the neurons of the brain and huge amount impulses corresponding to the norm. Such activity is chaotic, resulting in a malfunction of the brain and the development of a convulsive attack. The conclusion is that a seizure is not a disease, but a symptom. As for epilepsy, this is a condition during which typical seizures are repeated. The very concept of “epilepsy” has Greek origin and means “attack”. Such seizures are common in the United States, where approximately one in every hundred residents suffers from them. However, a single epileptic seizure in itself does not mean the onset and development of the disease.

Sometimes convulsive seizures occur for no apparent reason. The occurrence of some of them can be explained for the following reasons: brain injuries, tumors of the intracranial space, consequences of a stroke, consequences of infectious lesions of the body, impaired metabolism, hormonal imbalances in the body, consequences of the disease diabetes mellitus, excessive consumption of alcoholic beverages and drugs.

Convulsive attack with loss of consciousness

A convulsive attack with loss of consciousness is observed in diseases of various forms of epilepsy. One of these is juvenile absence epilepsy, which is one of the forms of idiopathic generalized epilepsy, the onset of which lies in puberty. A similar form of epilepsy manifests itself in typical absence seizures.

This type of epilepsy is common on a scale of up to three percent of total number all types of epilepsy and up to ten percent among types of idiopathic generalized epilepsy in adults over twenty years of age. In three quarters of all cases, there is a hereditary predisposition to this species diseases.

The clinical picture of this type of epilepsy is a sudden manifestation of periods of instant “freezing”, loss of consciousness over a period of time from several seconds to several minutes. The attack itself occurs within a few seconds. It is accompanied by loss of all orientation in space, interruption of all activities, blackout of consciousness for the period of “freezing”, absent gaze during an attack. The patient is not able to independently track the process of loss of consciousness. Moments of “switching off” consciousness can occur several times a day. Basically, such seizures occur upon awakening or during sleep (up to 60% of all cases). With a certain frequency, attacks may occur with convulsive contractions of the muscles of the whole body with biting the tongue and involuntary urination (up to 70% of all cases).

When conducting an objective examination of the patient, it may be impossible to identify pathological abnormalities in his neurological status, however, absence seizures and generalized tonic-clonic seizures are detected.

Seizure in sleep

If we talk about the time of manifestation of epileptic seizures, in relation to different daily periods, they can be divided into nocturnal attacks, mainly nocturnal, seizures that occur at any time of the day, only during the day. The standard time of onset of epilepsy attacks during sleep is waking up or falling asleep, particularly during excessively early forced awakening or sleep deprivation.

Using statistical calculations, it was found that among all patients suffering from epileptic seizures, only a third have exclusively nocturnal epileptic seizures. Various data indicate approximately 10-45% of such patients among the total number.

This form of epilepsy is informally called “nocturnal” epilepsy because it is associated with sleep. It should be recognized that there is no such term in epileptology.

A certain set of terms related to events occurring during sleep is identified: convulsive epileptic seizures occurring during sleep, nocturnal seizures, nocturnal paroxysms, seizures that occur when falling asleep, awakening or against the background of sleep deprivation, paroxysms that occur during sleep against the background of non-epileptic genesis , various forms of parasomnia, including somnambulism (sleepwalking) and somnillaquia (sleep talking), insomnia, disruptions in sleep processing, hyperkinesis, benign myoclonus and other options.

The wide variability of manifestations in sleep determines such a variety of various terms, and also indicates the high frequency of paroxysms and the associated complexity of diagnosis. There are all sorts of combinations of various sleep disorders associated with epilepsy and seizures that have nothing to do with it.

Epilepsy with generalized seizures

Epilepsy with generalized seizures or idiopathic epilepsy with isolated generalized convulsive seizures is a benign disease with a clinical picture based on tonic-clonic seizures. This disease usually begins in adolescence, around 12-15 years. TO this disease There may be a genetic predisposition.

The seizure occurs suddenly, without any preliminary part. The initial phase of the attack is clonic and lasts from ten seconds to half a minute. The patient suddenly loses consciousness and falls with a loud cry, which occurs as a result of a spasm of the vocal cords. After this, a strong tension occurs in all muscle groups, as a result of which the body bends back, legs and arms are extended. The eyes remain open, the pupils dilate, breathing stops, and facial cyanosis occurs. After which the attack passes into the second phase - clonic, which lasts up to ten minutes in the most difficult case. The patient involuntarily takes a deep breath, all the muscles of the body twitch, and these twitching gradually turns into rhythmic contractions. Breathing is wheezing, foam is released from the mouth, often stained with blood resulting from biting the tongue, and sometimes involuntary urination occurs. After the attack, the patient experiences some lethargy, is weakened and quickly falls asleep.

The frequency of epileptic seizures varies from once or twice a year to once a month. Attacks can be triggered by disturbances in the daily routine, interruptions in sleep, drinking alcohol or narcotic drugs, violent awakenings. IN clinical picture diseases of secondary types epileptic seizures are simple absence seizures.

A neurological examination of patients with this type of epilepsy does not reveal any abnormalities. The diagnosis is based on eyewitness testimony describing the attack, since the patient is unconscious at the time of the attack and cannot describe it. The patient undergoes an EEG, which reveals activities without a certain asymmetry, while no deviations from the norm are detected.

Seizure first aid

When a person falls as a result of convulsions, you should try to catch him and, if possible, lay him on a soft horizontal surface. True, this cannot be done if the seizure occurred in transport or on the street. If this happens, you should, first of all, isolate the patient from objects that can injure him - anything sharp, cutting, piercing. Often, this requires the help of other people, since the convulsions can be so strong that it is difficult to hold the patient alone.

To prevent oxygen starvation, the chest and neck should be freed from constricting clothing and the head should be turned to the side in order to prevent the patient from choking on vomit.

To prevent the tongue from sinking, you should insert a spatula into the patient’s teeth and press it against the root of the tongue if possible. Fulfill this procedure it is necessary to be very careful, since the patient may involuntarily clench his teeth and this will injure the person providing assistance if he inserts his fingers into the patient’s mouth.

Standard, public medications are not suitable for providing first aid to a patient with epileptic seizure. To stop convulsive contractions, the patient should be given an intravenous diazepam solution in a volume of 0.3 ml per kilogram of his weight, the dose is calculated approximately. If the effect is insufficient, the injection should be repeated after 10-15 minutes.

Seizure treatment

If possible, treatment for seizures should begin as early as possible, since this makes it possible to stop the development of the disease and prevent changes in the patient’s psyche. After the disease has manifested itself, an encephalography should be done and treatment prescribed if a cluster is detected nerve cells. Treatment takes a long time. Medicines stop taking it only after two to three years of taking it, earlier talk about complete cure no need to.

Seizure in a child

Seizures in children are very common, and their occurrence can be explained by many reasons. The most common factor explaining their appearance is the fact that the brain of children is still in the developmental stage and this determines the high excitability of the child’s nervous system. Children have extremely thin vessel walls and the penetration of various infections due to this circumstance is not difficult. The result may be swelling of the brain, accompanied by seizures.

In addition, seizures can occur as a result of exposure to many other factors that influence the development of the child in the womb, during childbirth and in the first months of an infant’s life.

It's called epilepsy chronic illness, manifested by convulsive seizures, vomiting, loss of consciousness and others no less dangerous symptoms. Counts neurological disease, which is treated by neurologists. Attacks occur both during the day and at night. But when they disturb a person only during sleep, then the disease is called “nocturnal epilepsy.”

Epileptic syndrome most often occurs in children 6-7 years old, as well as young people under 35 summer age. Feature disease - can go away on its own without special treatment. This happens due to age-related changes in the nervous system.

Causes of nocturnal epilepsy

Genetic predisposition is one of the main causes of the disease. There is a high chance that children whose parents have epilepsy will also experience seizures.

The development of the disease is promoted by:

• head injuries;
• overexcitation of the nervous system;
• drinking alcoholic beverages;
• sleep disturbance.

Sleep is an integral part human life, thanks to which the nervous system and body fully rest. When a person suffering from epilepsy sleeps less than expected, this will lead to more frequent attacks. Provoking factors: night shifts, partying, night awakenings, late going to bed. The nervous system is depleted, and brain cells become vulnerable.

The cause of more frequent attacks may be sudden changes in time zones. Patients with epilepsy should be careful when traveling. The sharp ringing of an alarm clock is a seemingly insignificant factor in the life of every person, but for epileptics it can be dangerous (a sudden awakening provokes an attack).

Symptoms of nocturnal epilepsy

A seizure that occurs only during sleep is a symptom of nocturnal epilepsy. Sometimes it bothers the patient even during daytime rest.

Epilepsy in sleep is characterized by:

• sudden, causeless awakenings;
• convulsive conditions;
• nausea and vomiting;
• dysarthria;
• severe headaches;
• a person creates unusual sounds reminiscent of squelching;
• trembling;
• distortion of the eyes, sometimes the face.

In a dream, the patient can get on all fours, making movements with his legs that are reminiscent of riding a bicycle.

Seizures during nocturnal epilepsy last from a few seconds to 2-5 minutes. Children, as a rule, do not remember events that happened at night during sleep. But some people retain their memory and can describe their sensations.

Indirect symptoms that are important to pay attention to:

• traces of blood appeared on the pillow;
• there are abrasions and bruises of unknown origin on the body;
• tongue bitten;
• muscle pain;
• wet bed (involuntary urination);
• a man wakes up on the floor.

Classification of nocturnal epilepsy attacks in medicine

1. Parasomnias. Symptoms:

• involuntary shuddering of the lower extremities at the moment when a person falls asleep;
• short-term immobility upon awakening.

1. Sleepwalking. Symptoms:

• sleepwalking;
• nightmares;
• urinary incontinence during sleep.

Children are more susceptible to sleepwalking. Usually it goes away on its own with age, but sometimes it does not stop and continues in adults. When a person walks in his sleep, there is a possibility of injury, because at this moment he does not control his movements. Another symptom of sleepwalking is aggression during awakening. Neither children nor adults remember anything that happened to them at night during sleep.

1. Bed-wetting. In medicine, this symptom is distinguished in separate species(if no other signs are observed). The brain cannot control the state of the bladder at the time of its filling, so it empties randomly, so that the patient does not even have time to wake up at this moment. Bedwetting is typical for children under 14 years of age (mostly boys). Involuntary urination occurs approximately 4 hours after falling asleep.

Not to be confused with epilepsy!

There are some symptoms that are not related to this disease. Children, sometimes adults, wake up at night due to fears and nightmares. They are confused with epileptic seizures. Some children sit down and cry in their sleep, and do not respond to the comforts of their parents, but there are no convulsions. The child, after a few minutes, calms down and goes back to sleep.

Some people experience muscle twitching when falling asleep. The body relaxes in preparation for sleep, and this provokes “benign sleep myoclonus.” It does not pose any danger and does not require treatment.

First aid

The goal is to protect the patient from possible injury. It is necessary to provide a soft surface for the person during an attack, which should be flat. You can use a blanket or clothes for this. If the patient is wearing pajamas, then, if possible, they should be removed so that the body is not constrained. The head is turned to the side so that the vomit comes out freely and does not enter the respiratory tract.

Until the attack is over, you should hold your limbs, but you cannot resist the convulsions. To prevent tongue biting and protect teeth from possible fractures, you should insert it into your mouth if possible. soft cloth(for example, a handkerchief).

During an attack, loved ones who are trying to help should know that it is strictly forbidden to unclench closed teeth! Forcibly opening the jaw can cause damage to teeth and may also injure the person helping.

Diagnosis of epilepsy

If a person develops symptoms that are alarming, they should immediately consult a doctor. Parents immediately notice changes that occur during sleep in their children, but with adults it is not so easy (especially if there is no one around at night).

Before prescribing treatment, the doctor must make a diagnosis. To do this you will need to do:

• sleep deprivation test;
• night EEG monitoring.

Treatment of epilepsy

Nocturnal epilepsy is considered the most mild form disease, its treatment does not cause any particular difficulties. But if the patient does not take antiepileptic drugs, then there is a risk of developing attacks during the daytime. Dosage medicine prescribed depending on the intensity of the seizures.

Treatment also requires compliance with a number of rules:

1. If the medications prescribed by the doctor cause drowsiness during the day or insomnia at night, then in such cases the doctor should be notified. He will prescribe another medicine.
2. Develop a regular habit: going to bed at the same time. If a person does not get enough sleep at night, then there is a risk of an attack during the day.
3. Reception sedatives, caffeine makes the situation worse.
4. A child with nocturnal epilepsy should have a bed with sides. You can also lay something soft near the bed.
5. Children with this disease should not sleep on a bunk bed.
6. Avoid using high pillows, which increase the risk of suffocation.

Correctly selected treatment improves a person’s quality of life. If the disease concerns a child, then his parents will be able to rest peacefully without worrying about their baby at night.

Epilepsy is a brain pathology in which seizures recur periodically and begin suddenly. This condition negatively affects many important processes in the body and makes the quality of life much worse, creating many problems for the patient. Every hundredth person on earth suffers from this disease, and it is one of the most common. Unpredictable attacks can strike a person at any time of the day or night.

Characteristic

Epilepsy attacks often occur at night. A seizure during sleep activates a group of neurons that are located in the focus of excitation, which provokes seizures. This condition occurs much more mildly during sleep than at other times of the day.

If epilepsy is in a generalized form, then convulsions occur at the moment of awakening and are characterized by trembling of some muscles. In some cases, facial muscles twitch, involuntary squinting of the eyes occurs, and limbs twitch. In general, it is difficult to describe attacks of nocturnal epilepsy, since everyone experiences them differently.

This syndrome very often worries people from 7 to 40 years old. There are cases when epilepsy goes away on its own during sleep. This can occur due to changes in the nervous system with age. The person gets older, the system improves, and the seizures go away.

If epilepsy attacks have been noticed during sleep, then experts note that the focus is localized in the frontal parts of the brain. This pathology is called frontal lobe epilepsy.

Most often it has a hereditary basis and is initially noticed in adolescence. Such attacks can be very frequent and appear against a background of stress, nervous tension, anxiety or drinking alcoholic beverages.

Nocturnal epilepsy in children

Very often, nocturnal epilepsy in children occurs due to brain injury. Most often, this pathology develops after a birth injury, the appearance of an infection that affects the brain, or a head injury. In some cases, this disease manifests itself as genetic. That is, a child inherits epilepsy from his parents or close relatives.

In a child, nocturnal seizures and convulsions can begin due to sleep disturbances, stress, or for no apparent reason at all, as an age-related manifestation. Parents do not always immediately notice this pathology, since all signs of the disease appear at night, when everyone is sleeping. Therefore, some children are unsupervised for a long time during attacks.

Forms of parasomnia attacks

Night attacks are divided into the following types:

• Parasomnias. In this case, involuntary shuddering of the lower extremities occurs. Upon awakening, their temporary immobility is noticed.
• Sleepwalking. This type of parasomnia occurs mainly in childhood and ends with adulthood. In this case, the child suffers from nightmares and urinary incontinence. If sleepwalking does not go away with age, then a person in this state may cause bodily harm to himself and exhibit aggressive behavior during awakening. After a person wakes up, he does not remember what happened to him. The brain cannot control such a manifestation as urinary incontinence. When full, the bladder empties automatically, but the child does not understand that he wants to go to the toilet and does not have time to wake up. This syndrome most often occurs in boys under 14 years of age.

Types of manifestation

Nocturnal epilepsy has the following forms:

1. Frontal.
2. Temporal.
3. Occipital.

But if we consider the disease in general, then this form of epilepsy is considered quite mild and has a favorable prognosis and is easily treatable.

Autosomal dominant nocturnal frontal epilepsy appears around the age of 7-12 years and is a manifestation of a gene defect. This pathology is characterized by frequent awakenings, dystonia, and convulsions. All this can happen several times a night.

Epilepsy with centrotemporal spikes is most common in children, most often manifesting between the ages of 5 and 12 years. In this case, problems with swallowing, convulsions, paresthesia, speech problems, and increased salivation are noticed. The person is conscious at this time. This type of epilepsy is very often simply related to the age of the child. Symptoms appear in the first stage of sleep and before awakening. In most cases, the disease resolves on its own with adulthood.

Electrical sleep status epilepticus is an encephalopathy, which is also an age-related pathology. It manifests itself in delta sleep in the form of attacks. The disease manifests itself from 2 months to 12 years and can negatively affect the development of psychomotor skills.

The following also develops against the background of the disease:

• aggressive behavior;
• short-term muteness, talking, incoherent speech;
• lag in development, mental retardation;
• syndrome that develops from a lack attention;
• strong excitation, nervousness.

Landau-Kleffner acquired aphasia syndrome. This type of nocturnal epilepsy occurs between the ages of 2 and 8 years. This pathology manifests itself in the non-REM sleep phase. The child wakes up for no reason during the attacks.

Idiopathic generalized epilepsy is noticed between the ages of 2 and 10 years. Basically, the disease is activated immediately after waking up. During an attack, shoulders and arms twitch, unconsciousness and problems with sleep appear.

When do seizures most often occur?

Sleep has several stages. Most of the seizures occur at the moment of falling asleep, that is, in the light phase of sleep. Attacks also occur during awakenings in the middle of the night and in the morning.

Despite the fact that the pathology has not been fully studied, experts note that it is the brain and its activity that is directly related to seizures. It is believed that during sleep there are a large number of different changes and seizures occur at certain times of sleep and wakefulness.

Cramps can become active at any time, but they were mainly noticed during the first and second stages of sleep. That is, most often seizures can appear:

• In the 1st or 2nd hour after falling asleep.
• If awakening happened 1-2 hours earlier than expected.
• In the morning within 1.5 hours after the person wakes up.

Cramps may also occur after a nap.

Causes

Since epilepsy has not been fully studied by specialists, the exact cause of its origin is difficult to voice. But there are suggestions that can provoke pathology:

• Hypoxia or oxygen starvation.
• Ancestral injury.
• Neoplasms in the area of ​​the brain.
• Inflammatory process in the brain area.
• Pathological intrauterine development.
• Infections.
• Injury brain.

Patients with nocturnal epilepsy are advised to control their sleep time and not reduce it. Otherwise, it will provoke more frequent attacks. Such people are not recommended to work at night. Also, the causes of seizures include a very loud sound of an alarm clock and a change in time zones.

Symptoms

The main symptom of nocturnal epilepsy is seizures that occur only during sleep and awakening. Also, epilepsy during sleep can manifest itself as follows:

• nausea and bouts of vomiting;
• convulsions;
• shiver;
• conversations in a dream;
• sleepwalking;
• Problems with sleep;
• nightmares;
• voltage all muscles;
• involuntary urination;
• frequent awakening, having no reason;
• dysarthria.

In some cases, distortion of the face and eyes is noticed. The patient may move involuntarily in his sleep, get on all fours, and make other movements. The attacks do not take long and can last about 10 seconds.

How to stay safe

It has been established that improper sleep, its restriction or lack of sleep can lead to consequences in the form of night attacks. Therefore, it is necessary to create all conditions for a patient with nocturnal epilepsy:

1. The best bed to choose low with a back trimmed with soft material. Two-tier and ra
2. Composite structures are not recommended.
3. It is not advisable to sleep on large and very soft pillows, which may cause suffocation.
4. It is best to place the bed away from different furniture, this will help prevent injury.
5. You can place it near your sleeping area mats or other protective structures, mats that will be relevant in case of a fall.
6. Lamps It is best to use wall lamps, and table lamps should be excluded.
7. Rough carpets It is best to remove it from the bed, otherwise rubbing against it may cause injuries to the skin.

By following safety rules, you can eliminate the unpleasant consequences of seizures and convulsions.

Diagnostics

Diagnosis is initially carried out by familiarizing yourself with the complaints and external examination of the patient. Instrumental diagnostics are also performed - electroencephalography.

Electroencephalography (EEG) is one of the main methods that helps identify nocturnal epilepsy. This diagnostic method helps to detect high-amplitude peaks and waves that provoke convulsions and seizures.

Since the symptoms of the disease manifest themselves mainly at night, in addition to the daytime EEG diagnosis, a night EEG is also performed. They also suggest going through:

• video monitoring;
• teleencephalographic monitoring.

Differential diagnostics are also carried out, which will help exclude other pathologies.

Therapy

Nocturnal epilepsy is one of the simplest forms of the disease and treatment is not particularly difficult. But if the patient does not want to take special medications prescribed by the doctor, then, most likely, attacks will begin to appear during the daytime and the disease will develop into a more complex form.

Antiepileptic drugs are mainly prescribed, where the dosage is calculated for each patient individually, calculating the frequency of attacks and the duration of their duration.

During therapy, you must follow some rules:

• If you experience drowsiness during the day after taking medications and insomnia at night, you should definitely contact doctor and tell him about it. Most likely, the drug will be changed to another
• It is advisable to sleep go to bed at the same time and do not violate this schedule. The patient should get enough sleep to avoid daytime manifestations of the disease.
• Prohibited to accept caffeine and sedative medications - this can negatively affect the entire treatment and interfere with positive results.

It is also worth taking care of safety rules.

Prevention

Prevention of nocturnal epilepsy is as follows:

• Correct nutrition.
• Active Lifestyle.
• Evocation alcohol.
• Walks in the fresh air.
• Exception stress, nervous overstrain, depression.
• Refusal of night duty, 24/7 work.

And most importantly, we need to improve night sleep as much as possible and make sure that the person gets enough sleep. To do this, you can ventilate the room, choose the right bedding, mattress and pillow, do not wear uncomfortable night clothes, do not overeat before bed, and drink a glass of warm milk.

Consequences and complications

If you start treating the disease in time and protect your sleeping place, then complications and consequences can be avoided. But you should know that the disease is dangerous:

• injuries;
• chronic lack of sleep;
• day lethargy and drowsiness;
• attacks at other times of the day;
• night nightmares;
• oxygen fasting;
• pain in muscles as a consequence of cramps;
• bad well-being;
• reduction immunity.

Despite the fact that the disease does not have a high risk of development, it should not be left completely unattended. You need to undergo a full diagnosis, adjust your lifestyle and follow the doctor’s recommendations.