Sleep and Epilepsy Syndromes

Abstract

Sleep and epilepsy have a close relationship. About 20% of patients suffer seizures only during the night, approximately 40% only during the day and approximately 35% during the day and night. In certain epilepsy syndromes, the occurrence of seizures is strongly related to sleep or awakening. Infantile spasms appear predominately on awakening, and hypsarrhythmia is sometimes visible only in sleep. Children with Panayiotopoulos syndrome or benign epilepsy with centrotemporal spikes (BECTS) have seizures mostly when asleep, and in both syndromes interictal spike waves are markedly accentuated in slow wave sleep. Electrical status epilepticus during slow sleep/continuous spike wave discharges during sleep (ESES/CSWS), atypical benign partial epilepsy, and Landau?Kleffner syndrome are epileptic encephalopathies with substantial behavioral and cognitive deficits, various seizures, and continuous spike?wave activity during non?rapid eye movement (NREM) sleep. The hallmark of juvenile myoclonic epilepsy and grand mal seizures on awakening are seizure symptoms within 2 hours after awakening, often provoked by sleep deprivation. Nocturnal frontal lobe epilepsy is sometimes mistaken for parasomnia. Differentiation is possible when the clinical symptoms and the frequency of the paroxysmal events per night and month are carefully observed and nocturnal video electroencephalography (EEG) performed. Sleep EEG recordings may be helpful in patients with suspected epilepsy and nonconclusive awake EEG. Depending on the clinical question, sleep recordings should be performed during nap (natural sleep or drug induced), during the night, or after sleep deprivation.

Semiology, clustering, periodicity and natural history of seizures in an experimental visual cortical epilepsy model

“…37,38 Approximately 20% of people with epilepsy have predominately nocturnal seizures. 39 Thalamocortical synchronization has been invoked to account for this association. 40,41 Circadian changes at many different levels have been proposed to explain the relationships between epilepsy and circadian rhythm.…”

Advances in the Management of Sleep Disorders in Juvenile Myoclonic Epilepsy

“…(3) Identifying and treating SDs and understanding the effect of circadian rhythms on JME can improve QL and control of seizures.…”

“…It is important that doctors should not require applying restrictions, because excessive regimentation may be counterproductive. (3) In addition, the formation of the menstrual cycle in girls, which is also a proconvulsant, plays an important role at this time.…”

“…B.Schmitt showed that about 20% of patients suffer seizures only at night, approximately 40% only during the day and approximately 35% during day and night. (3) That is more than half of patients have nocturnal seizures during sleep.…”

High risk of developing subsequent epilepsy in patients with sleep-disordered breathing

“…Occasionally, spikes with hypersynchronization lead to an epileptic seizure. Sleep deprivation increases seizure susceptibility and often provokes epileptic seizures [9,10]. Among SLDs, sleep apnea, also known as sleep-disordered breathing (SDB), is thought as one of severe conditions and often associated with other medical disorders, which probably including epilepsy.…”