Activation Effects of Sleep Deprivation and Sleep in Seizure Patients

Correlations between occurrence of complex partial seizures and altered sleep duration were analyzed in a small but strongly homogeneous population of temporal lobe epilepsy patients. Sleep deprivation and oversleep were determined individually; 682 epileptic seizures occurring on 4,995 days were related to occasional alterations of night sleep duration. The seizure-inducing effect of an actual relative sleep deprivation was 67-100% in four cases and 49-64% in four cases. Oversleep had no consistent seizure-provoking effect. Relative sleep deprivation may have a seizure-provoking effect, especially in temporal lobe epilepsy. This information may be used to instruct epileptic patients concerning sleep hygiene which might improve the efficacy of antiepileptic drug (AED) treatment, even if no change is made in medication.

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“…The same effect has been hypothesized to occur in humans (Bennett et al, 1969;Scollo-Lavizzari et al, 1975).…”

Section: Discussionsupporting

confidence: 58%

Correlations Between Night Sleep Duration and Seizure Frequency in Temporal Lobe Epilepsy

Rajna

Veres

1993

Epilepsia

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“…High activation rates of epileptic activity in sleep without sleep deprivation Degen, 1981, 1983a;Christian, 1961;Ganshirt and Vetter, 1961;Gibbs and Gibbs, 1947;Jovanovic, 1967] as well as with sleep deprivation [Bechinger et al, 1973;Bechinger and Kornhuber, 1976;Degen, 1977Degen, , 1980aDegen, 1981, 1983a;Gastaut et al, 1984;Kubicki et al, 1984;Matt son et al, 1965;Pratt et al, 1968;Ritter et al, 1977;Scollo-Lavizzari et al, 1975, 1977Wittenberger and Kubicki, 1977] are re ported in the literature. As sleep deprivation is very troublesome both for the patients and the staff, we questioned whether in fact sleep after sleep deprivation gives a higher activa tion rate than normal sleep.…”

Section: Discussionmentioning

confidence: 99%

Sleep EEG with or without Sleep Deprivation?

Degen¹,

Degen²,

Reker³

1987

Eur Neurol

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A sleep EEG of 190 patients without sleep deprivation was recorded, followed by a sleep EEG after 24 h of sleep deprivation on the next day. The patients suffered from various types of epilepsy, in their routine EEGs no epileptic discharges were seen. Both sleep EEGs were recorded under the same antiepileptic drugs. A waking EEG was recorded immediately before each sleep EEG. The activation rates of epileptic activity in 52.6% (without sleep deprivation) and 53.2% (with sleep deprivation) of the patients showed no significant differences. Also on classifying the epileptic discharges no real difference was found between the 2 methods (generalized: 29.5 vs. 29.5%, generalized with lateral emphasis: 11.1 vs. 9.5%, focal: 12.1 vs. 14.2%). Only in the waking EEG, recorded immediately before the sleep EEG after sleep deprivation, a few more patients showed epileptic discharges (33.6 vs. 27.4%). Without there being any significant differences between the 2 methods there were some different results in comparing the EEG with the clinical findings: significantly more epileptic activity was shown in patients who had their first seizure before the age of 20 (55.6 and 55.6 % vs. 26.3 and 31.6%), amongst females (59.8 and 61.9% vs. 45.2 and 44.1%), in awakening grand mal (= primary generalized tonic-clonic seizures, 76.5 and 70%) and in absences (69 and 72.4%). The higher activation rates in young subjects, in patients with a family history of seizures, with pathological neurological findings, mental retardation and delayed psychomotoric development in early childhood, were not statistically significant. As sleep deprivation is troublesome both for the patients and the staff, and as the same rate of patients show epileptic discharges in sleep without and with sleep deprivation, this method is dispensable for clinical practice.

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“…Even though age is considered critical for SD-EEG outcome, in some reports both adults and children have been included in the same group [5, 6, 8, 10, 16, 21, 24, 25, 28–34]. Moreover, although occurrence of IIA during the first routine wake EEG could be considered as an exclusion criterion in studies testing SD-EEG sensitivity, this aspect is sometimes not evaluated or not considered as a bias (see, e.g., [6, 10, 11, 15, 16, 20, 29, 33, 35]).…”

Section: Variability In Sd-eeg Protocol and Examined Populationmentioning

confidence: 99%

Controversial Issues on EEG after Sleep Deprivation for the Diagnosis of Epilepsy

Giorgi

Maestri

Guida

et al. 2013

Epilepsy Research and Treatment

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EEG after sleep deprivation (SD-EEG) is widely used in many epilepsy centers as an important tool in the epilepsy diagnosis process. However, after more than 40 years of use, there are a number of issues which still need to be clarified concerning its features and role. In particular, the many scientific papers addressing its role in epilepsy diagnosis often differ remarkably from each other in terms of the type of patients assessed, their description and study design. Furthermore, also the length and the type of EEG performed after SD, as well as the length of SD itself, vary dramatically from one study to another. In this paper we shortly underscore the abovementioned differences among the different reports, as well as some interpretations of the findings obtained in the different studies. This analysis emphasizes, if needed, how SD-EEG still represents a crucial step in epilepsy diagnosis, and how additional, controlled studies might further shape its precise diagnostic/prognostic role.

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Activation Effects of Sleep Deprivation and Sleep in Seizure Patients

Cited by 30 publications

References 5 publications

Correlations Between Night Sleep Duration and Seizure Frequency in Temporal Lobe Epilepsy

Correlations Between Night Sleep Duration and Seizure Frequency in Temporal Lobe Epilepsy

Sleep EEG with or without Sleep Deprivation?

Controversial Issues on EEG after Sleep Deprivation for the Diagnosis of Epilepsy

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