Seizure in my sleep, how does this change things?

[Autumn Breeze]

I have read that if it's PNES, there aren't seizure in sleep.

What about the length of a seizure? My husband says mine last a bit more than 2 minutes, which I've seen is more likely during PNES.

 

[Nakamova]

Psychogenic non-epileptic aren't well understood. (And I happen to think that they are over-diagnosed). They can mimic any kind of epileptic seizure, but they're considered a physical manifestation of psychologic distress, and recommended treatment involves psychotherapy rather than anti-seizure drugs.

The following details are considered to be possible markers for non-epileptic seizures:

1. Ability of observer to modify the patient’s motor activity
2. Asynchronous limb movements
3. Avoidance behavior during seizures
4. Change in symptomatology, or nonstereotypical seizure patterns
5. Closed eyes during seizures
6. Dystonic posturing (including rigid arching of the back)
7. Emotional or situational trigger for the seizures
8. Gradual onset and cessation of seizures
9. Crying and weeping during the seizure.
10. If tongue biting is present, usually the tip (not the side) of the tongue
11. Intermittent or waxing and waning motor activity
12. Pelvic movements (especially forward thrusting)
13. Prolonged seizures (duration of 2 to 3 minutes)
14. Resisted eyelid opening
15. Seizures provoked by suggestion
16. Side-to-side head movements

Not all seizures with these features are psychogenic nonepileptic seizures, however. Frontal lobe seizures often are mistaken for nonepileptic seizures because of the associated dramatic motor and vocal outbursts, semi-awareness, and short postictal period. And...frontal lobe seizures tend to begin during sleep. So I would agree that onset during sleep would tend to indicate that the seizures are epileptic rather than non-epileptic in origin.

 

[Autumn Breeze]

Thanks!!

I typically experience no warning, but my husband says I go rigid and cry out, and I'm stiff for a little while before I start flailing my arms. My arm movements are symmetric, and I'm unclear as to what's going on with my legs. This part lasts longer. Sometimes when I'm calming down I'll flail again a couple times. During this time it sounds like I'm coughing/trying to breath. My eyes tear up, but I'm not crying. As it ends I tend to want to "look forward" and my husband tries to move my head to the side so I can drool/breath.

The postictal lasts 30-45 minutes before I begin speaking/understanding again. After this last one, he said it was about that long before he thought I could actually swallow the ativan. It's small enough I don't need water. The ativan makes me sleep for about 4 -5 hours before I'm awake before any significant amount of time.

:e: