Brief Answer:
Nocturnal seizures vs. Hypnogogic Jerks

Detailed Answer:
Good afternoon. My name is Dr. Dariush Saghafi and I am an adult neurologist from XXXXXXX Ohio, USA

I am happy to answer this question for you but my response will necessarily be brief since you have not provided very much description or other detail.

If you believe you are having true seizures and that this is of new onset then, you must get yourself to a neurologist for a full evaluation ASAP. However, let's see if we can't help direct you a little bit by asking these simple questions.

When you say "seizures" are you perhaps referring to things that are more like TWITCHES or body jerks which begin at the point where you start to get tired or sleepy as sometimes happens when people start nodding to sleep and then, they suddenly "catch themselves" but before they fully come to they may twitch a few times in the head, the hands or the legs? Or when you say "seizures" are you talking about full blown Grand Mal events which we call TONIC CLONIC SPELLS WHERE both arms and legs and head are jerking very rhythmically and very strongly to the point of moving the entire bed or biting your tongue, or pee'ing on yourself, or losing your bowels on yourself?

In the first instance the twitches and single body jerks upon falling asleep are referred to as HYPNAGOGIC JERKS. In fact, at that time people can sometimes report having funny hallucinations or feeling very lightheaded or disoriented a bit until they jerk and then, generally they wake up.

In the 2nd described instance what I've described would be consistent with a full blown epileptic episode and probably termed NOCTURNAL SEIZURE DISORDER. This would have to require a pretty extensive workup since you are 58 years old and we would want to figure out why you're having these types of episodes just out of the blue.

HYPNAGOGIC JERKS or if with hallucinations HYNAGOGIC HALLUCINATIONS are actually fairly frequent phenomenon...babies actually do it very frequently. Just watch what happens when the baby's just starting to fall asleep....parts of the limbs and head may suddenly jerk once or twice...to the point where sometimes the baby actually wakes up...and then, they are cranky, sometimes disoriented, and scared. Well, something very similar happens to adults and they can be confused a bit, or even hallucinating. However, this is considered normal and happens especially in people who are extremely tired, swing shift workers, or those who have been up for long periods of time and who are exhausted and fatigued.

Bottom line, in either case my suggestion is that you get worked up by a neurologist so they can get the chance to see and examine you as well as order appropriate bloodwork, urine, imaging studies of the head, and a brainwave study. Treatment in the case of epilepsy is easy and usually quite effective. Treatment for the other is usually very nondescript and does not require more than making sure you are WELL RESTED, WELL HYDRATED, and not engaging in risky behaviors with cocaine, speed, or other illicit drugs, etc.

I hope this answer satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, I'd appreciate it greatly if you would CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary.

Please direct more comments and questions to me in the future at:

bit.ly/drdariushsaghafi and I would be honored to answer you and continue this discussion.

All the best.


The query has required a total of 18 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
Again- hard to say without either an EEG or video of the event

Detailed Answer:
Good evening. Thank you for the updated information. I don't know the answer to your question without more information. You should get a full neurological examination complete with lab work and very possibly some type of study such as an electroencephalogram (EEG) as well as an imaging study of the head such as a CT or better yet MRI (with gadolinium contrast and fine cuts through the temporal lobes). This is the standard imaging study we do when confronted with patients with the possibility of seizure like episodes.

Morphine sulfate is well known to cause "twitches of the arms, legs, head, and trunk. These are called myoclonic jerks. But they happen throughout the day while a person is taking the drug as a side effect not just at specific times such as what you are describing which is just going to bed.

A video of your jerks and twitches would be very helpful as well as an EEG to be able to definitely classify what you've got. Also, are they any eyewitnesses (family members, spouse, friends, the mailman?) that can write their descriptions down of what is going on. Can they verify whether or not you are coherent and able to speak or would they say that you are "zoned out" during these episodes?

These are additional things to consider. But you really do need to get to someone who can perform a good neurological exam on you as well as get more information from a witness to these events if you can produce one who is able to go along with you to the visit. You should also get lab work, an EEG, and an MRI as I've described with fine temporal lobe cuts as part of your workup.

I hope this answer satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, I'd appreciate it greatly if you would CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary.

Please direct more comments and questions to me in the future at:

bit.ly/drdariushsaghafi and I would be honored to answer you and continue this discussion.

All the best.


The query has required a total of 27 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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