What are the initial symptoms of sleep-related epilepsy?

Written by Liu Shi Xiang
Neurology
Updated on March 15, 2025
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The initial symptoms of sleep-related epilepsy mainly include sudden opening of the eyes and panic symptoms at the onset of sleep. A few patients may exhibit aggressive behavior towards others, and some may experience movement disorders and abnormal muscle tone. For these patients, it is necessary to promptly receive examinations and treatment in neurology. Diagnostic methods mainly include video EEG, ambulatory EEG, cranial CT, and MRI, among others. Once diagnosed, timely intervention should be provided. For some patients, if it is the first seizure and not frequent, interventions through lifestyle and sleep adjustments can be implemented without immediately resorting to medication. If these adjustments are ineffective or if the patient frequently experiences seizures, appropriate medications should be administered in a timely manner, including drugs such as sodium valproate, carbamazepine, oxcarbazepine, and levetiracetam, among others. (Medication should be taken under the guidance of a doctor)

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Written by Yan Xin Liang
Pediatrics
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What are the symptoms of epilepsy in children?

The typical symptoms of childhood epilepsy include sudden loss of consciousness, followed initially by tonic and then clonic convulsions, often accompanied by screaming, cyanotic facial complexion, frothing or bleeding at the mouth, dilated pupils, generally lasting 40 seconds or up to 15 minutes. The convulsive seizure stops naturally, followed by a state of coma. Of course, some affected children also display varying degrees of consciousness disorders, evident disruptions in thinking, perception, emotion, and psychomotor functions, and may show signs of conditions like somnambulism and noctambulism, among other automatisms.

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Written by Liu Shi Xiang
Neurology
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Why does epilepsy occur at night?

Epilepsy that occurs at night is called sleep-related epilepsy. There are many reasons for this phenomenon, such as excessive fatigue, irregular sleep, menstrual onset, anxiety, depression, and more. Additionally, some patients exhale more carbon dioxide during sleep, causing hyperventilation and internal environmental imbalances, which can easily lead to abnormal discharges of brain neurons. When some patients experience symptoms of epilepsy at night, timely intervention and treatment are needed. First, patients should develop a good lifestyle, go to bed on time, get up on time, avoid staying up late, and avoid excessive fatigue. Furthermore, targeted medication should be given to prevent the onset of the condition. Common medications include lamotrigine, levetiracetam, carbamazepine, and sodium valproate. Besides, patients also need to maintain a good mindset and avoid tense and anxious emotions that could exacerbate symptoms.

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Written by Tang Li Li
Neurology
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What causes epilepsy in the elderly?

If a patient has no history of epilepsy but begins to experience epileptic seizures in old age, it is generally secondary epilepsy, also known as symptomatic epilepsy. All patients should have a clear cause, but with current diagnostic techniques, it is not always possible to find the cause. If the cause cannot be identified, it is called cryptogenic epilepsy. In such cases, it is generally necessary to improve diagnostic methods, such as cranial magnetic resonance imaging (MRI) and cranial magnetic resonance angiography. The most common causes of epilepsy in the elderly are generally cerebrovascular disease, brain trauma, or encephalitis, and in some cases, brain tumors. Any disease that causes brain cell damage can potentially cause symptomatic epileptic seizures. If all imaging examinations fail to reveal any abnormalities, regular follow-ups are necessary to monitor for early-stage tumors that may not be detectable on imaging tests. Meanwhile, antiepileptic treatment should be administered, and routine blood tests, liver, and kidney functions should be regularly monitored.

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Written by Yan Xin Liang
Pediatrics
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Precursors to epileptic seizures in children

The majority of childhood epilepsy seizures occur without any precursors, as they arise and cease suddenly with stereotyped movements. However, some seizures are preceded by prodromes, such as sudden onset of consciousness disturbances, or fainting symptoms. Other seizures can present with motor dysfunctions, displaying sudden weakness or fatigue in certain limbs, followed by an epileptic attack. Additionally, some may experience abnormal sensations, such as numbness in a specific area or visual disturbances, including sudden flashes or even visual distortions, leading to convulsive seizures.

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Written by Yuan Jun Li
Neurology
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What are the signs before the onset of epilepsy?

Before the onset of epilepsy, most patients do not exhibit any signs and can suddenly experience an epileptic seizure. Different types of epilepsy have different symptoms. For example, during a major seizure, symptoms can include limb twitching, eyes rolling upwards, frothing at the mouth, clenched teeth, loss of consciousness, and abnormal blood pressure, which can lead to severe falls and injuries. During a minor seizure, the patient mainly shows transient loss of consciousness, objects in hand may suddenly drop, unresponsiveness when called, and a vacant stare. Most patients do not fall, and the symptoms generally last for only a few seconds to tens of seconds. If autonomic epileptic seizures are considered, symptoms may include nausea and vomiting. Psychotic symptom seizures can present with hallucinations and delusions.