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November 01, 2022; 99 (18) Disputes & Debates: Editors’ Choice

Editors' Note: Identification and Characterization of Pure Sleep Epilepsy in a Cohort of Patients With a First Seizure

Ariane Lewis, Steven Galetta
First published October 31, 2022, DOI: https://doi.org/10.1212/WNL.0000000000201431
Ariane Lewis
MD
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Steven Galetta
MD
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Steven Galetta
MD, FAAN
Roles: Editor
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Aravind Ganesh
MD, DPhil, FRCPC
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Ariane Lewis
MD
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James E. Siegler III
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Editors' Note: Identification and Characterization of Pure Sleep Epilepsy in a Cohort of Patients With a First Seizure
Ariane Lewis, Steven Galetta
Neurology Nov 2022, 99 (18) 817; DOI: 10.1212/WNL.0000000000201431

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In “Identification and Characterization of Pure Sleep Epilepsy In a Cohort of Patients With a First Seizure,” Pang et al. studied 239 adults with first unprovoked seizure during sleep and found that while one-third had subsequent awake seizures, the annual risk of an awake seizure was ≤14% and decreased with time. Coebergh commented that obstructive sleep apnea (OSA) is a potential etiology for nocturnal seizures, particularly in older or obese patients, and proposed that future research evaluate OSA as a treatable risk factor. Pang agreed that untreated OSA could lead to seizures and that future studies should assess the relationship between OSA and seizure recurrence. However, Pang noted that they found no relationship between seizure recurrence and age, sex, or obesity. Nonetheless, both parties emphasize that OSA can be a potentially important and treatable cause of nocturnal seizures.

In “Identification and Characterization of Pure Sleep Epilepsy In a Cohort of Patients With a First Seizure,” Pang et al. studied 239 adults with first unprovoked seizure during sleep and found that while one-third had subsequent awake seizures, the annual risk of an awake seizure was ≤14% and decreased with time. Coebergh commented that obstructive sleep apnea (OSA) is a potential etiology for nocturnal seizures, particularly in older or obese patients, and proposed that future research evaluate OSA as a treatable risk factor. Pang agreed that untreated OSA could lead to seizures and that future studies should assess the relationship between OSA and seizure recurrence. However, Pang noted that they found no relationship between seizure recurrence and age, sex, or obesity. Nonetheless, both parties emphasize that OSA can be a potentially important and treatable cause of nocturnal seizures.

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