Questions
The patient experiences intermittent spasms between their arms just as they fall asleep each night, which decrease in the latter half of the night. What could this be?
Answers
The symptoms described by the patient may be related to sleep movement disorders or focal epilepsy. It is recommended to undergo dynamic electroencephalography or polysomnography to determine the cause. If brain lesions need to be ruled out, a cranial magnetic resonance imaging scan may also be necessary. The diagnosis of epilepsy typically requires specific clinical manifestations, such as limb convulsions, sensory abnormalities, loss of consciousness, urinary or fecal incontinence, as well as changes in mood and behavior. Electroencephalograms can record spikes and spike-wave complexes characteristic of epilepsy. If there are no obvious epilepsy symptoms, it is advisable to observe first and rule out possibilities such as syncope, hypoglycemia, recurrent sleepiness, and hysteria. If epilepsy is diagnosed, medication treatment is the main method. Medications should be taken regularly and checked periodically, avoiding triggers such as alcohol and fatigue. Surgery is applicable for intractable epilepsy that does not respond to medication treatment. If medication is missed, it should be taken as soon as possible or the medication schedule should be adjusted. Further examinations are needed to clarify the cause of the condition, and treatment should be tailored to the underlying cause.