Polysomnographic documentation of seizures in a patient with obstructive sleep apnea syndrome

Abstract

Obstructive sleep apnea syndrome (OSAS) occurs in 2 to 4% of the adult working population of the United States.1 OSAS is due to a collapse of the oropharyngeal airway during sleep, leading to a decrease or cessation of ventilation up to several hundred times a night. Apneas are usually followed by electrocortical arousals (5 to 15 seconds) or awakenings(>15 seconds), resulting in severe sleep disruption and cumulative sleep deprivation. Neurologic consequences of sleep apnea include excessive daytime sleepiness,2 increased risk for stroke, impaired psychomotor performance, fatigue, mental slowing, and confusional states. Sleep deprivation can precipitate seizures in most patients with epilepsy.3 Patients with refractory seizures and OSAS showed improved seizure control after treatment of OSAS.4-6 We report clinical and polysomnographic findings in a patient with medically refractory epilepsy and sleep apnea syndrome who had two seizures during polysomnography. Case report. A 68-year-old man presented with nocturnal primary and secondarily generalized seizures. The events began with staring and right gaze deviation, often followed by a generalized tonic-clonic …