4-yr-old/sleep disorder or seizures?

  Hello,
  My 4-yr-old daughter has been having sleep disturbances for at least 6 to 8 months or more. I finally began documenting them in August.
  Every few weeks (sometimes more frequently, sometimes less), I awake to her crying--a kind of choking cry rather than normal. It is often within 2 hours of her going to bed. When I go to her she doesn't really wake up. Often she is sitting up. A few times she seemed to nod or shake her head to my questions, but she refuses to talk at all. It doesn't seem to fit the "night terror" descriptions I've found.
  The crying is accompanied by a rhythmic chill. Every ten to thirty seconds she'll have a shaking chill, and her teeth will chatter too (no matter the season or temperature!). You can pick her up, cover her, talk to her, yet the mild shaking and choking/chattering continues. The last two times this happened and I noticed her eyes were open just before the chill, and they seemed to roll up and she closed them as she shook. It's a trembly shake, not a wild movement. (I used to notice that she was very sweaty when this happened, although the last few times she hasn't been as damp.) She tends to gather herself up into a ball at these times.
  This will go on for about 4-5 minutes and then she will drift back asleep. She has no recollection of this in the morning.
  I've never seen anything like this whatsoever during waking hours. She has no other chronic complaints although she is often very tired for a 4-year-old, I think.
  The last episode she had was last night--that made 4 in a month. This time she was sweaty and much more trembly than usual, and seemed almost frightened by it--although she wouldn't answer any questions. The trembles seemed to come at closer intervals and be more pronounced. It even scared me.
  Does this resemble a seizure at all? If not, what could be happening? I've mentioned it to family and friends and no one can relate to this behavior. I am trying to reach our doctor about it--previously I have felt strange about describing such weird symptoms.
  Thanks for any input you can offer.

[HFHS.RN-AM]

Nightmares and night terrors are common around this age. When the child awakes, they need to be reassured in a comforting way in a dimly lit bedroom. Frequent episodes should be investigated for possible daytime environmental factors that might be precipitating these frightening dreams. With night terrors, the child will not likely remember being afraid the next morning, whereas with nightmares, they can usually remember the dream with vivid details. Night terrors can be frustrating to parents because they can not comfort the child. They usually start with a terrifying scream accompanied by an autonomic response which includes sweating and shaking (the fight or flight symptoms). The child looks fearful and attempts to console may even make the episode worse. Some things that distinguish terrors from nightmares include: they occur in the first 1/3 of the night, children are unarousable to wakefulness, there is amnesia of the event afterward and easy return to sleep. Additionally, there can be a family history of terrors. Nightmares on the other hand occur in the mid to last 1/3 of sleep, the child arouses easily, there is no amnesia and it is very difficult for the child to return to sleep because of the vivid memory.
As these episodes are usually self-limiting, they usually run their course. Stress, fatigue and illness can make them worse. In some cases, scheduled awakenings may be helpful prior to the time the events usually occur. If the events are unusual such as in the early morning, or there are repetitive tonic-clonic movements, nocturnal seizures need to be ruled out by a pediatric neurologist. Do not hesitate to discuss your observations with the pediatrician. These symptoms are really quite common and well documented in the literature.
This information is provided for educational purposes only and should not take the place of a doctors evaluation.
HFHS.RN-AM
*KEYWORD: nightmares, night terrors, sleep disturbances, seizures