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Obstructive and central sleep apnoea in a patient with medically intractable epilepsy
  1. Katherine Schwartz1,
  2. Alejandra C Lastra2 and
  3. Antoaneta J Balabanov3
  1. 1Department of Neurology, Advocate Aurora Healthcare, Park Ridge, Illinois, USA
  2. 2Section of Pulmonary and Critical Care Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
  3. 3Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
  1. Correspondence to Dr Katherine Schwartz; katherine.schwartz{at}


A woman in her 30s with medically intractable epilepsy and Lennox-Gastaut Syndrome on multiple antiseizure medications and with a deep brain stimulator presented to the epilepsy monitoring unit with increased seizure frequency. She was noted to have periods of apparent apnoea time linked to bursts of epileptiform activity on continuous video EEG monitoring. Once the clinical seizures were controlled, she was discharged to the sleep laboratory. She was noted to have obstructive and central sleep apnoea, which improved with the use of positive airway pressure. Central sleep apnoeas were time linked to electrographic seizures. Ictal central apnoea can easily be overlooked and is likely more common than currently recognised in patients with epilepsy. Ictal central apnoea may be a biomarker for sudden unexpected death in epilepsy.

  • neurology
  • epilepsy and seizures
  • sleep disorders (neurology)

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  • Contributors KS, AJB and ACL all cared for the patient. KS wrote the case report with editing help from AJB and ACL.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.