Nocturnal epilepsy in adults

Epileptic seizures are often strongly influenced by the sleep-wake cycle. In many patients, seizures occur predominantly or exclusively during sleep. These cases can often represent a diagnostic dilemma. A high degree of suspicion combined with knowledge of the characteristics that distinguish nocturnal epileptic seizures from other nocturnal paroxysmal events is necessary to make the diagnosis. This article will review characteristics of nocturnal epileptic seizures in adults, including etiology, clinical semiology, differential diagnosis, and treatment.