Twitching and possible seizure in sleep

[Cameron1]

My girlfriend, who is diabetic, recently had an episode in her sleep that I have come to believe was a seizure.  She woke up in the middle of the night trembling and unresponsive.  I thought it had something to do with her blood sugar being low, so I gave her some orange juice.  Gradually, she came around, not really knowing what had just happened.  I assumed that this was related to her diabetes and the fact that we were both pretty stressed out (this was on the night of Sept 12, just after the terrorist attacks in NY and DC).  Since that night, I have not slept very well, waking up several times during the course of the night just to check on her.  I'm afraid that I haven't let her sleep soundly through the night since then.  However, I have been noticing that she is twitching a lot in her sleep, especially just as she goes to sleep and in the morning.  I could be just noticing something that has always happened because I am obsessing on her sleep patterns.  Her doctors tell her that she is their best diabetic patient and she is otherwise healthy.



1. Is it likely that the seizure was connected to these twitches?

2. Could I be making these twitches worse by not allowing her to sleep soundly through the night?

[CCF-Neuro-M.D.-JT]

It's hard to say what that episode really was. From your description of "trembling", it just seems that your first reaction was absolutely correct which was to give her juice for hypoglycemia. Think back to see if there was hard jerking of her arms and legs, stiffness of her body, gaze deviation, loss of urine or stool in the bed. If there was, then it was probably a seizure. If not, then I'm more apt to think it was hypoglycemia. She may need to start checking her sugars regularly and adjusting her night time dose of insulin or diabetic med.



We all get little twitches in sleep. However, if the twitches are keeping her from sleeping and occur at the onset of sleep, she may have a sleep disorder called hypnic jerks or somnolescent starts. These are not associated with epilepsy but may need to be treated.



It's understandable that you're both quite stressed as many people are right now. However, unless she is truly bothered by these twitches in the day or night and has a real bonafide seizure - let your girlfriend sleep, and try to get some yourself. Best of luck.

[Cameron1]

Thanks for your response.  I think that she may have had a seizure.  Her whole body would shake for a second and then she would be still for a few seconds.  Her legs were stiff and her hands were partially clenched.  Her eyes were open, but she clearly wasn't aware of what was going on.  She was able to respond to her name, but not able to answer questions.  She was not thrashing violently, and I was able to prop her up on some pillows and she was able to drink the OJ that I was pouring into her mouth.  She came around very gradually, and at first was very confused and just wanted to go back to sleep.  Once she was finally back to normal, she felt fine and almost seemed to be in a good mood.



I understand that hypoglycemia can result in a seizure, so I initially chalked this up to low blood sugar.  She is usually very precise about monitoring her blood sugar and insulin intake.  The night time twitching since this episode is what concerns me.  However, for all I know, it may have always been there and I am just overly sensitive to it now.  Is this something I should tell her to get checked out?