Sleep-Related Seizures in Children: Cohort Study from a Tertiary Center

Background and objective: Sleep-related epilepsy (SRE) is nocturnal seizures that manifest during the sleep state. It affects 12%-20% of epileptic patients, specifically those suffering from focal epilepsy. SRE is often misdiagnosed as a sleep disorder, especially in cases where the seizures manifest exclusively during sleep. This work aimed to study SRE, etiology, semiology, and electroencephalogram (EEG) characters and to determine their outcome regarding seizure control on properly selected anti-seizure medications (ASMs). Methodology: This study enrolled one hundred patients who fulfilled the inclusion criteria. All of them were subjected to history taking, full examination, seizure semiology analysis, inter-ictal EEG recordings, and magnetic resonance imaging (MRI). Results: Patients with self-limited epilepsy with centro-temporal spikes (SeLECTS) were the most common epilepsy syndrome (52%), followed by sleep-related hypermotor seizures (SHE) (33%), then patients with self-limited epilepsy with autonomic symptoms (SeLEAS). Around 79% of the patients had sleep seizures, while 21% had seizures during sleep and wakefulness. Also, oxcarbazepine (OXC) was the most used first ASM in 62% of our patients, followed by levetiracetam (LEV) in 28% of the patients. Conclusion: SeLECTS, SHE, and SeLEAS are three of the most frequently implicated epilepsy syndromes occurring during the sleep state. Oxcarbazepine was the most effective drug to control seizures.