SLEEP ATTACKS MIMICKING EPILEPTIC SEIZURES AND PSEUDOSEIZURES

Common treatable sleep disorders resulting in excessive daytime sleepi ness may resemble or contribute to spells of altered responsiveness. T hese spells may mimic epileptic seizures or other paroxysmal disorders . Three patients presented with paroxysmal spells of altered responsiv eness that were attributed initially to epileptic seizures or pseudose izures. One patient had a history of childhood epilepsy and was referr ed for the concern of recurrent seizures. In another patient, antiepil eptic drugs (AEDS) were prescribed for suspected epileptic seizures wi thout an improvement in spells. After their physicians obtained a hist ory of excessive daytime sleepiness, snoring, and/or restless leg symp toms, patients were evaluated with polysomnography, multiple sleep lat ency tests, electroencephalograms (EEC), and video-EEG monitoring. Sle ep studies were diagnostic of obstructive sleep apnea, periodic limb m ovement disorder, and probable narcolepsy. In all patients, spells of altered responsiveness and excessive daytime sleepiness improved or re solved 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 disord ers. Identification and treatment of an underlying sleep disorder may contribute to resolution of their spells. (C) 1997 by Elsevier Science Inc. All rights reserved.