Papilledema and Seizure like Episodes in a Patient with Obstructive Sleep Apnea Syndrome: a Case Presentation and Literature Review

Obstructive sleep apnea (OSA) syndrome is a common sleep-related breathing disorder characterized by repeated episodes of the upper airway collapse during sleep. Loud snoring and daytime sleepiness are the main complaints; however, the condition may present with a variety of symptoms and signs.
Case Report: A 65-year-old woman was admitted to neurology ward with the diagnosis of intractable seizures. The physical examination revealed papilledema and huge obesity with body mass index of 41. Brain imaging was unremarkable. The pressure of cerebrospinal fluid was 33 cm H2O. As respiratory distress was observed, pulmonary evaluations were conducted. Finally, an overnight polysomnography confirmed the diagnosis of severe OSA. Positive airway pressure removed the symptoms.
This presentation suggests that severe OSA should be considered as a differential diagnosis for epilepsy and a probable cause of raised intracranial pressure, especially at the presence of obesity.