Abstract
We studied the clinical features of GTCs occurring only during sleep (so-called sleep-grand mal).
In most patients, seizures occurred early in the morning or soon after falling asleep. The occurrence of seizure is apparently related to sleep stage.
Age at onset was under 20 years in 15 cases (75%). Most of cases (75%) were seizure-free for more than three years with various antiepileptics therapy. Therefore, the prognosis of sleep-grand mal was fairly good. Refractory cases showed significantly longer duration from seizure onset to initiation of treatment than controlled cases.
Awake EEGs showed no epileptic discharges in all cases. But, sleep records, including polysomnography, demonstrated focal seizure discharges in the temporal or frontal region. There were no generalized seizure discharges at any recordings. It is therefore suggested that sleep-grand mal is primarily a localizat ion-related epilepsy.
