Episodi convulsivi notturni in paziente con sindrome delle apnee ostruttive durante sonno

We report the clinical history of a patient (female, 37 years old) with a mild obesity (BMI 33.5). Family history of epilepsy was negative. The patient examination was normal. Four months ago, during nocturnal sleep, the patient presented an event characterized by generalized jerks, lasting for few seconds with a consequent fall from bed, followed by headache and confusional state. Further four events with the same features happened in the following months, in the last of which there was urinary incontinence. Furthermore the patient complained an excessive daytime sleepiness. We performed a polysomnography which showed a severe obstructive sleep apnea syndrome. A cardiologic evaluation with EKG was normal. A laboratory polysomnography showed, during REMsleep, many events of bradycardia and ventricular extrasystoles and two episodes of asystolia lasting for 6 and 9 seconds, with a polygraphic pattern of syncope. Another polysomnography performed during nocturnal ventilation with continous positive airway pressure (CPAP) didn't show any asystole event.