Effects of sleep and sleep stage on epileptic and nonepileptic seizures
Effects of sleep and sleep stage on epileptic and nonepileptic seizures
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DOI：
10.1111/j.1528-1157.1997.tb01077.x
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发表时间：
1997-01-01
期刊：
影响因子：
5.6
通讯作者：
Walczak, TS
中科院分区：
文献类型：
--
作者：
Bazil, CW;Walczak, TS
目的.先前对癫痫患者和癫痫动物模型的研究表明，睡眠增加了癫痫发作的频率、持续时间和继发性全身性发作。然而，这一信息是不完整的。方法：我们回顾性研究了视频脑电图监测报告，从我们的综合癫痫中心。我们记录发作类型、发作部位（部分性发作）、发作时的睡眠状态以及部分性发作是否继发全身性发作。睡眠引起的癫痫发作，然后审查，以确定sleep state.Results：我们分析了188例患者的1,116次癫痫发作。35%的复杂部分性癫痫发作（CPS）在睡眠中开始，与清醒时的18%相比，经历了二次泛化（p < 0.0001）。额叶CPS在睡眠（22%）和清醒（20%）期间以相同的速率其次泛化，但颞叶CPS在睡眠（45%）期间比清醒（19%; p < 0.0001）更频繁地泛化。额叶癫痫发作更可能发生在睡眠期间（37%）比颞叶癫痫发作（26%; p = 0.0068）。CPS在第1和第2阶段更常见，在REM期间很少发生。在慢波睡眠期间开始的癫痫发作明显长于在清醒或第2阶段睡眠期间开始的癫痫发作。心因性非癫痫发作（PNESS）是罕见的午夜和上午6时之间，从来没有发生在sleep.Conclusions：睡眠有一个显着的影响继发性全身性部分性癫痫发作，特别是那些颞叶起源。额叶癫痫发作在睡眠中比颞叶癫痫发作更常见，睡眠中的发生有助于区分PNESS和CPS。
Purpose. Previous studies of patients with epilepsy and animal models of epilepsy suggest that sleep increases the frequency, duration, and secondary generalization of seizures. This information is, however, incomplete.Methods: We retrospectively examined video-EEG monitoring reports from our comprehensive epilepsy center. We recorded seizure type, site of onset (for partial seizures), sleep state at onset, and whether partial seizures secondarily generalized. Seizures arising from sleep were then reviewed to determine sleep state.Results: We analyzed 1,116 seizures in 188 patients. Thirty-five percent of complex partial seizures (CPSs) starting during sleep underwent secondary generalization compared with 18% in wakefulness (p < 0.0001). Frontal lobe CPSs secondarily generalized at equal rates during sleep (22%) and wakefulness (20%), but temporal lobe CPSs generalized much more frequently during sleep (45%) than in wakefulness (19%; p < 0.0001). Frontal lobe seizures were more likely to occur during sleep (37%) than were temporal lobe seizures (26%; p = 0.0068). CPSs were more frequent in stages 1 and 2 and occurred rarely during REM. Seizures starting during slow-wave sleep were significantly longer than seizures starting during wakefulness or stage 2 sleep. Psychogenic nonepileptic seizures (PNESs) were rare between midnight and 6 a.m, and never occurred during sleep.Conclusions: Sleep has a pronounced effect on secondary generalization of partial seizures, especially those of temporal lobe origin. Frontal lobe seizures occur more often during sleep than do temporal lobe seizures, and occurrence during sleep helps to distinguish PNESs from CPSs.