Can Epilepsy That Only Occurs During Sleep Be Cured?

Epilepsy is a neurological disorder characterized by recurrent seizures, and for many patients, it can be effectively managed or even cured through proper treatment. Approximately 70% of epilepsy patients can achieve complete remission with treatments such as antiepileptic drugs, vagus nerve stimulation, neuromodulation therapy, and surgical interventions. This includes patients whose seizures predominantly occur during sleep. However, about 20% to 30% of individuals may not respond well to these treatments, leading to what is known as drug-resistant or refractory epilepsy.

Why Seizures Happen During Sleep

Seizures that occur exclusively during sleep are often linked to changes in brain activity during different sleep stages. In healthy individuals, the brain cortex reduces its excitability during sleep, which helps maintain a balanced and stable brain state. This regulation is also influenced by the ascending reticular activating system in the brainstem, which normally helps control arousal and consciousness.

Brain Activity and Seizure Triggers

In people with epilepsy, the normal inhibitory functions of the cerebral cortex and the excitatory effects of the reticular activating system are diminished during sleep. This creates a favorable environment for abnormal electrical discharges in the brain, which can lead to seizures. Importantly, this tendency to seize during sleep does not necessarily impact the overall prognosis of epilepsy treatment.

For patients experiencing nighttime seizures, identifying the underlying cause and tailoring an individualized treatment plan is crucial. With the right approach, even sleep-related epilepsy can often be controlled or resolved, significantly improving the patient's quality of life.