[Epilepsy with generalized convulsive seizures on awakening (epilepsy with generalized tonic-clonic seizures "around sleep")]

Abstract

Seventy patients with idiopathic epilepsy with generalized tonic-clonic seizures (GTCS) on awakening were analyzed. In 30% of patients, seizures occurred with the same frequency or less often only on falling asleep. Two groups of patients were specified: with isolated GTCS on awakening and with a combination of the latter with myoclonia and absences. Awakening as a factor provoking seizures can be significant not only for night sleep but also for day sleep, mostly in patients with isolated GTCS. This allows to define the syndrome as an epilepsy with GTCS "around sleep". At the same time, there were 6 patients with clinical and EEG features of symptomatic epilepsy. Heterogeneity of the syndrome with GTCS "around sleep" is also related to the mental state of patients and their response to AED: carbamazepine is more effective in patients with isolated GTCS and valproate in those with the combination of GTCS with myoclonia and absences.