Identification and treatment of obstructive sleep apnea in adults and children with epilepsy: a prospective pilot study
Identification and treatment of obstructive sleep apnea in adults and children with epilepsy: a prospective pilot study
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DOI：
10.1016/j.sleep.2003.06.004
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发表时间：
2003-11-01
期刊：
影响因子：
4.8
通讯作者：
Binns, LA
中科院分区：
文献类型：
--
作者：
Malow, BA;Weatherwax, KJ;Binns, LA
目的：前瞻性研究阻塞性睡眠呼吸暂停(OSA)对成人和儿童癫痫发作频率的影响。几个病例系列记录了共存的OSA治疗后癫痫发作控制的改善，但发表的系列没有对临床人群进行样本调查，设计不具前瞻性，也没有考虑抗癫痫药物(AED)剂量或水平的同时变化。患者和方法：在密歇根大学癫痫和儿科神经科诊所看到的成人患者和儿童患者的父母接受了有效的问卷调查。选择13名成人(年龄20-56岁)和5名儿童(14-17岁)进行多导睡眠监测(PSG)，根据发作频率和阻塞性睡眠呼吸暂停的风险。比较8周基线和治疗阶段的癫痫发作频率和AED水平，以证明药物水平的稳定性。结果：13名成人中有6名和5名儿童中有3名符合PSG的OSA标准。三名成人和一名儿童接受了持续气道正压(CPAP)治疗，对该装置耐受，AED剂量没有变化；在CPAP治疗期间，所有四人的癫痫发作频率至少减少了45%。1名成人使用口腔矫治器治疗，仅减少夜间癫痫发作，2名成人和2名儿童不能接受CPAP。结论：OSA对癫痫患者的治疗可能会改善癫痫的发作控制，似乎有必要进行一项大规模的随机安慰剂对照试验。(C)2003爱思唯尔B.V.保留所有权利。
Objective: To determine the effect of treating obstructive sleep apnea (OSA) on seizure frequency in adults and children with epilepsy in a prospective study. Several case series documented an improvement in seizure control with treatment of coexisting OSA, but published series did not sample a clinic population, were not prospective in design, and did not account for concurrent changes in antiepileptic drug (AED) doses or levels.Patients and methods: Adult patients and the parents of pediatric patients seen in the University of Michigan Epilepsy and Pediatric Neurology Clinics were given validated questionnaires. Thirteen adults (aged 20-56) and 5 children (aged 14-17) were selected for polysomnography (PSG) based on frequency of seizures and risk for OSA. Seizure frequency was compared during 8-week baseline and treatment phases and AED levels were done to document stability in medication levels.Results: Six of 13 adults and 3 of 5 children met PSG criteria for OSA. Three adults and I child were treated with continuous positive airway pressure (CPAP), were tolerant of the device, and had no change in AED doses; all four had at least a 45% reduction in seizure frequency during CPAP treatment. One adult was treated with an oral appliance with a reduction in nocturnal seizures only, and 2 adults and 2 children were intolerant of CPAP.Conclusions: Treatment of OSA in patients with epilepsy may improve seizure control and a large randomized placebo-controlled trial appear warranted. (C) 2003 Elsevier B.V. All rights reserved.