Epileptic seizures and sleep–wake rhythm

The subjects were 25 children, including West syndrome, Lennox–Gastaut syndrome, childhood absence epilepsy (CAE) and localization‐related epilepsies. Clinical seizures occurred only during waking state in 14 patients (including the cases of West syndrome, CAE and epilepsy with myoclonic absences (EMA)), only during sleeping state (especially during non‐REM sleep in five patients, including the case of benign epilepsy with centrotemporal spike), and diffusely during waking and sleeping states in six patients (including the case of early infantile epileptic encephalopathy with suppression burst). These three types were observed in the cases of Lennox–Gastaut syndrome and localization‐related epilepsies. Subclinical ictal discharges occurred during REM sleep in West syndrome, and during REM and non‐REM sleep especially during non‐REM sleep in CAE and EMA.