4-year-old/Are these seizures?

  Dear Doctor,
  My 4-year-old has been having strange sleep disturbances over the last several months. The symptoms are very strange, and I have hesitated to call the pediatrician because of that. However I was wondering if these occurrences sound like they are neurologic in nature. If so I would definitely make that call.
  Every few weeks (sometimes more frequently, sometimes less), I awake to my daughter crying--a kind of choking cry rather than normal. When I go to her she doesn't wake up. Sometimes she is sitting up. She seems somewhat aware of my arrival because she may nod or shake her head to my questions, but won't talk at all. (So I don't think it's a night terror.)
  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. Last week 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. I want to stress that this is just a small shake, not a wild movement. Her teeth always chatter though. (I used to notice that she was very sweaty when this happened, although the last few times she hasn't been as damp.)
  This will go on for about 4-5 minutes and then she will be 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.
  Also, I should mention her brother has a mitochondrial disorder, a complex III deficiency. She has none of his symptoms. And he has not exhibited this sleeping problem.
  Any suggestions would be appreciated!! (We'd all sleep a lot better.)
  Thanks so much.
Dear Hilory:
I am sorry to hear about your son (mitochondrial disease: How is his treatment going).  Also, about your daughter.  What I think is going on is a disorder called night terrors.  It is a sleep disorder that usually occurs out of stage III or IV sleep (deep sleep).  Mostly occurs during the first several hours of sleep, children wake up crying or screaming, can have some movements like shaking, then go back to sleep.  They do not remember the occurence and they usually will grow out of them.  Does this sound like your daughter?  The eyes rolling back are a sign that she is trying to close her eyes (a natural response).  However, as pediatric neurologist, we worry about epilepsy.  I don't think this is the case from your description.  I would, however, see a pediatric neurologist to confirm my thoughts.  To rule this possibility you will likely need a sleep EEG.  It is best to rule this possibility out.  This is the age that a condition known as benign focal epilepsy of childhood is manifested.
Best of luck, let us know what happens.
Sincerely,
CCF Neuro:Pediatrics MD, RPS