Self-limited epilepsy with centrotemporal spikes is the most common paediatric
epileptic syndrome, with growing evidence linking it to various degrees and
presentations of neuropsychological dysfunction. The objective of this study is
to evaluate the possible sleep macro and microstructural alterations in children
with this diagnosis. A systematic review of published manuscripts was carried
out in Medline, LILACS and Scielo databases, using the MeSH terms
epilepsy, sleep and polysomnography. From
753 retrieved references, 5 were selected, and data from macro and, when
available, microstructure of sleep were extracted. Meta-analysis was performed
with data from 4 studies using standardized mean difference. Findings were
heterogeneous between studies, being the most frequent macrostructural findings
a smaller proportion and greater latency of REM sleep in two studies and, in
meta-analysis, a longer sleep latency was the most significant finding among
epileptic patients. Only one study evaluated sleep microstructure, suggesting
possible alterations in cyclic alternating pattern in diagnosed children.
Studies evaluating macro and microstructure of sleep in children with
self-limited epilepsy with centrotemporal spikes are necessary to a better
understanding of mechanisms of the neuropsychologic disturbances that are
frequently seen in children with this diagnosis.
Objective: This study aimed to translate the Epworth sleepiness scale for children and adolescents (ESS-CHAD) into Brazilian Portuguese. Material and Methods: The translation and language validation processes were carried out through translation, back translation, technical review, assessment of verbal comprehension/clarity of the scale by experts (four pediatric neurologists). After they have reached a final version of the ESS-HAD a sample of asymptomatic children and adolescents that were participants in another sleep project were invited to read and complete the questionnaire to evaluate comprehension by the aimed population. Results: Two independent researchers made the forward translation and it has around 90% of concordance. Minor disagreements were related to the position of adjectives in the sentence. No major difficulties were reported by the 3 rd researcher that performed the back translation. After a consensus meeting with the four participants, we have reached a final version of the questionnaire. In the cognitive interviews, the scale was reportedly easy to understand to the 23 respondents. One adolescent suggested clarifying whether question 2 (likelihood of falling asleep watching TV or a video), referred to daytime or nighttime. The total ESS-CHAD score in this asymptomatic sample varied from 0-17, a mean score of 7.08±5.65. Discussion: The final version of the ESS-CHAD in Brazilian Portuguese was approved by the copyright owners and was well understandable by caregivers and adolescents. More studies are now necessary to use this questionnaire in a larger target population to verify its validity and internal consistency.
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