1: Neurol India. 2008 Apr-Jun;56(2):151-5.

Sleep seizures versus wake seizures: A comparative hospital study on clinical,
electroencephalographic and radiological profile.

Goel D, Mittal M, Bansal KK, Srivastav RK, Singhal A.

Department of Neurology, Himalayan Institute of Medical Sciences, Dehradun,
India.

Background: Epileptic seizures, predominantly or exclusively during sleep had
been the focus of attention for many electroencephalographers. Though few
epileptic syndromes are associated with sleep seizures (SS) its frequencies in
Indian patients is still unknown. Aim: To find out the patterns of epilepsies in
patients having SS and compare them with patients having wake seizures (WS).
Setting and Design : Open label hospital based study. Materials and Methods: One
hundred and forty-four (13%) patients having predominantly SS were compared with
976 (87%) patients of WS by various clinical, electrophysiological and
radiological factors. Statistical Analysis: Chi square test and student T test,
using software SPSS (version 10, 1999) was applied to compare various parameters.
Relative risk was calculated by 2 x 2 contingency table. Results: The seizure
semiology was better defined in patients with WS and GTCS was more common in SS (
P = 0.001). Wake-electroencephalogram (EEG) was abnormal in significantly ( P =
0.001) higher number of patients with WS. Symptomatic etiologies were found in
more than half patients. Left lobe involvement was more common in patients having
SS ( P = 0.000). After symptomatic, idiopathic generalized and frontal lobe
epilepsy were most frequent with SS. Undetermined epilepsy was found in 37
(25.7%) patients with SS. Conclusion: Epilepsies associated with SS were less
frequent and had symptomatic cause in most cases. Left hemispherical and frontal
lobe lesion were more commonly associated with SS. Frontal lobe and idiopathic
generalized epilepsy was most frequent in patients of SS. Sleep EEG should always
be done in patients with sleep seizures.