SLEEP AND EPILEPSY

The differential diagnosis of ''things that go bump in the night'' inc ludes parasomnias, sleep-related movement disorders, psychiatric condi tions, and epilepsy. This article focuses on the interactions between sleep, epilepsy, and the effects of antiepileptic medication, with an emphasis on avoiding misinterpretation of primary sleep disorders and epilepsies presenting during sleep. There are important effects of sle ep state on seizure activity, and there are equally important effects of epilepsy on sleep maintenance with implications on daytime alertnes s. Pointers to elicit appropriate history and examination are describe d; appropriate investigations including polysomnography and different electroencephalographic techniques can clarify difficult clinical dile mmas.