Can Dreams Be Causing Our 5 Year Old To Have 3 Nocturnal Seizures During REM Sleep?

We moved to a new city a little over 2 months ago. The move along with some other recent traumatic events (including an EEG which came back normal) has caused our son to have to cope with a lot of stress. We have noticed this appears to be reflected in his dreams, especially in the early mornings (REM) from approx 4:00AM to 6:30AM before he wakes up. He will often cry, yell or even laugh.

Our son has some developmental delays and sensory issues & has always been a highly sensitive child. He is also a mouth breather. In 2009 he was diagnosed with sleep apnea and had a tonsillectomy. This seemed to help him sleep better but he still breathes through his mouth. His ENT said his chin is slightly recessed and will need orthodontic help as he gets older to open up the jaw line.
Our son also gets into bed with us every night around midnight and falls back to sleep. He's been doing this for years and has never had any seizures before we moved.

The first seizure was at 6:45 AM while asleep and was approx one minute, he resumed breathing and fell back asleep. He did not foam at the mouth, turn blue or urinate.

9 day's later he had a second seizure at 4:15 AM, after recovering from an extremely stressful EEG that morning. We associated that particular seizure (which was 30 seconds) to his sleep cycle being off (to prepare for the EEG) and the stress of the test itself. The 3rd seizure was 9 days later for 30 seconds at 6:00AM. All three seizures were preceded by him making a noise as if he was having a bad dream.

He has not had another early morning seizure for almost 20 days now but he has continued to have bad dreams almost every morning. When we hear him having a dream we immediately start rubbing his back and verbally telling him that we are here, he is safe and having a dream. We are desperately trying to figure out if there is a connection between these seizures and his dreams since he never has them during the day and his EEG came back normal.

Thank you so much for your input.

Kevin's Response

Thanks very much for writing in and sharing your son's story. Unfortunately I don't know much myself about nocturnal seizures and am not going to be able to give you too much input. However, I would venture to guess that your son's seizures have less to do with the content of the dreams--whether they are good dreams or bad dreams--and more about the mechanisms of REM sleep, as you hinted.

I've heard before of some really profound connections between seizures and REM sleep. From nocturnal seizures being caused by the emergence out of REM sleep to daytime or nocturnal seizures dramatically affecting how much REM sleep is obtained that night. You also seem to know that REM occupies a much larger proportion of sleep later into the night, as REM periods get gradually longer while the non-REM periods between them get gradually shorter, and so percentage-wise it makes sense that your son's seizures would be happening in the morning if they are tied in some way to REM sleep or the emergence out of REM sleep.

I wish I had more knowledge and experience in this matter to help you more directly, but I have found a couple of articles that hopefully will be of some use to you, if you haven't already seen them.

The first is from the journal of European Neurology and is specifically about nocturnal seizures tied to REM sleep in the form of a case study of a 16-year-old boy who experienced them in the transition from REM to wakefulness. You can find the article at:

http://content.karger.com/ProdukteDB/produkte.asp?Doi=116383.

The second is a more general piece about the relationship between sleep and epilepsy written by a doctor from The Neurological Institute in New York. It's published on Epilepsy.com and the meatier bits of information that will probably be the most useful to you are found further down the page. Here's a link to the specific page:

http://www.epilepsy.com/articles/ar_1063155671

My thoughts are with you and your son. I really hope the doctors are able to make some progress and that your son doesn't have to go through many more EEGs. If I find out anything more about this, I'll be sure to let you know through updating this page.

Best wishes,
Kevin