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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Behavioral disturbances associated with the use of anticonvulsant therapy may be readily apparent and easily diagnosed. They are most commonly reported with the use of barbiturates and usually include hyperactivity, disturbed sleep, irritability, and emotional lability. But, subtle behavioral disturbances may also adversely affect performance and learning. Behavioral changes resulting from therapy with barbiturates and benzodiazepines tend to be idiosyncratic as opposed to the dose-related affects seen with phenytoin and valproate therapy. Carbamazepine and valproate can affect mood and behavior negatively, but, generally, this occurs less frequently than when several other anticonvulsants are used; this is especially true in patients without CNS damage. The suspicion that there may be a causal relationship between anticonvulsant therapy and impairment of cognitive skills in nonintoxicated patients is gaining increasing support. Neuropsychologic studies in acutely exposed normal volunteers, studies in epileptic patients receiving monotherapy, and crossover studies between drugs have incriminated barbiturates and hydantoin drugs. Memory/cognitive dysfunction, although affected to a greater extent with higher drug dosages, has been reported with levels within the therapeutic range. Thus, serum drug levels cannot be considered good predictors of which patients will have subtle side effects. Carbamazepine and valproate seem to be relatively free of many adverse neuropsychologic effects, although additional studies need to be performed. The complete separation of seizure effects from drug effects remains on ongoing goal. Similarly, in comparative studies to date, the issues of whether the differences between the drugs are due to negative effects of one or positive psychotropic effects of the other, or both, are not adequately addressed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:American Academy of Pediatrics. Behavioral and cognitive effects of anticonvulsant therapy. Committee on Drugs. 393 Oct 47

Sleep deprivation enhances seizure susceptibility in experimental and human epilepsies. Because sleep abnormalities are also common in these populations, a possible explanation for this close association is that sleep deprivation activates seizures by enhancing existing sleep disturbances. The present experiment examined this hypothesis by comparing sleep-waking state percentages and the number of after-discharge-eliciting stimulations required to induce generalized tonic-clonic convulsions with the amygdala kindling model of epilepsy in 3 groups of cats (n = 5 each). One group consisted of experimental subjects who received bilateral lesions of the basal forebrain, a preoptic area long implicated in the generation of normal sleep state characteristics. A second group sustained unilateral lesions of the basal forebrain area. Since only bilateral destruction of this region produces sleep-waking cycle abnormalities, this group provided a lesion control. Finally, a third group had no lesion and provided a control which allowed normative assessment of sleep state patterns and seizure susceptibility in otherwise unmanipulated cats. The results were: cats without lesions showed a parallel development of seizure and sleep disorders, the latter indexed by progressive SWS and REM sleep deficits; cats with unilateral lesions showed identical trends in the development of sleep and seizure anomalies; and cats with bilateral lesions of basal forebrain displayed similar but more severe sleep disturbances than those evidenced by control subjects and also required fewer after-discharge stimulations to establish kindled convulsions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Sleep disruption with basal forebrain lesions decreases latency to amygdala kindling in cats. 620 6

Four cases with intractable epilepsy and mental retardation (Epi + MR), four cases of mental retardation (MR), one case of mental retardation without epileptic seizures for the last several years (MR + (Epi] and two normal children were studied on their sleep pattern. Besides these, two cases of epilepsy (Epi) were examined. Awake time increased in the Epi + MR group. Slow wave sleep decreased markedly in the Epi + MR group. REM sleep decreased in the MR + (Epi) and Epi + MR groups. REM density was lowered in the following order: normal----Epi----MR----Epi + MR groups. The difference of sleep pattern among the normal, Epi and MR groups was not exhibited clearly, but severe sleep disturbances were shown in the Epi + MR group, implicating the severe brain dysfunction in the cortex and the brain stem.
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PMID:Sleep pattern in children with intractable epilepsy and mental retardation. 654 13

Three groups of adult epileptic subjects with simple partial, complex partial, and generalized seizures and normal control subjects completed a brief self-report sleep questionnaire. The simple partial and complex partial groups indicated significantly more sleep disorder symptoms, especially frequent night awakenings. The generalized group was most similar to the controls. Irrespective of seizure type, the epileptic patients with the most frequent seizures also had the most sleep disturbances. Sleep disorder symptoms did not increase with age in the seizure groups. It would thus seem that epileptic patients with partial seizures and those with more frequent seizures are at risk for developing sleep disorders.
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PMID:Self-reported sleep disorder symptoms in epilepsy. 674 15

It is well known that clinical symptoms such as psychosis, epileptic seizures and sleep disturbances aggravate around the time of menstruation. In some healthy women, subjective sleep feelings or moods have been reported to change throughout the menstrual cycle, which suggests that sleep structure and sleep-wake rhythm may change during the menstrual cycle. We investigated a circadian pattern of plasma melatonin, sleep-wake rhythm and sleep characteristics in the different phases of the menstrual cycle in young healthy women under controlled environmental conditions. The subjects were seven healthy women, aged 18 to 19, with regular menstrual cycles. They stayed in an experimental facility, where temperature and humidity were kept within a narrow range, for three days in successive five weeks. They got up and went to bed at their preferable time. Polysomnography was performed using ambulatory cassette EEG system on the first and second night. Sleep stages were scored according to Rechtshaffen and Kales' criteria. Plasma melatonin was measured at 1-hour intervals for 24 hours on the third day. The menstrual cycle was divided into four phases (menstruation, follicular, early luteal and late luteal). Although the plasma melatonin level in the late luteal phase tended to be higher than in other phases, no significant difference was observed across four phases. The phase in plasma melatonin level did not change. As for sleep-wake rhythm, the time of getting up on the first day was significantly late in the late luteal phase (p < 0.05), although it showed no significant change on the second day. The time of going to bed did not change. Sleep characteristics changed during the menstrual cycle. There was a significant difference in the amount of stage 3 + 4, slow wave sleep (p < 0.05), which was more abundant in the follicular phase than in the luteal phase. TIB (time in bed), SPT (sleep period time), TST (total sleep time) seemed to increase in the menstrual and follicular phases, while stage W increased in the early and late luteal phases. However, there were no significant differences in these parameters. The other parameters did not show any changes. The changes in amount of stage 3 + 4 throughout the menstrual cycle seem to be due to endogenous factors, because environmental factors were controlled in this experiment. It is possible that the menstrual cycle also affect the plasma melatonin level and sleep-wake rhythm.
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PMID:[Changes in biological rhythm and sleep structure during the menstrual cycle in healthy women]. 777 41

Sleepiness is a common complaint in the epilepsy clinic, and sleep disturbances are frequently reported by seizure patients. Polysomnography was performed in 6 patients with complex partial seizures, with and without secondary generalization, who had not yet started anticonvulsant treatment or whose medication had been discontinued. Five patients sleep through the night, but 1 slept only 3 hours. Two patients had reduced sleep efficiency and slow wave sleep was reduced or absent in 4 patients. No REM sleep disturbances occurred. Two patients had almost no periodic leg movements of sleep (PLMS), 2 had few or no arousals and PLMS indices of 5 or less, and 2 had markedly elevated PLMS and arousal indices. No apneas or significant hypopneas were recorded, but snoring indices were elevated in 2 patients. These findings suggest that sleep apnea is infrequent in unmedicated seizure patients. Some patients may have exaggerated PLMS with arousals, possibly related to epileptiform discharge and perhaps exacerbated by medications, but apparently not due to nocturnal seizures.
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PMID:Sleep apnea and periodic leg movements in epilepsy. 781 95

Whereas early formulations of addictive behaviour placed great emphasis upon withdrawal as a defining feature, current views focus more upon compulsive use as its central characteristic. However, the withdrawal syndrome continues to occupy an important place in the study of the addictions. It is interesting both in its own right and in relation to the development and maintenance of the compulsive use of drugs. Despite the attention devoted to withdrawal phenomena over many years, precise demarcation of the withdrawal symptoms associated with drugs of dependence has proved difficult to achieve. Withdrawal from all drugs of dependence appears to lead to mood disturbances although the extent to which these are due to the pharmacological actions of the drugs or to other physiological or psychological processes is unclear. Sleep disturbance is also common, although again direct links with the pharmacological actions of the withdrawn drug are yet to be established. Withdrawal from alcohol, benzodiazepines and opiates is often associated with somatic symptoms. In the former two cases, these can involve sweating, tremor and occasionally seizures. Perceptual disturbances have also been reported. In the case of opiates, flu-like symptoms are often reported, including muscle aches and gastric disturbances. In the case of nicotine, heightened irritability has been established as a direct pharmacological withdrawal effect. Characterization of stimulant withdrawal is still uncertain. There is little evidence of somatic symptoms but depression may occur as a result of a physiological rebound. There is also uncertainty over what role pharmacological withdrawal symptoms play in maintaining compulsive use.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Overview: a comparison of withdrawal symptoms from different drug classes. 784 60

We report the ontogeny and persistence of sleep and arousal disorders in amygdala-kindled kittens. We also identify procedural differences that may explain discrepancies in the literature on postkindling sleep disorders. The study population consisted of 12 preadolescent kittens kindled between 2.5 and 6.5 months of age, 8 of which were followed to adulthood (> or = 1 year), and 8 unkindled implanted control animals. Sleep and seizure patterns were monitored on 12-24-h polygraphic or split-screen video recordings of EEG and behavioral activity. Kindled kittens displayed spontaneous seizure and interictal sleep anomalies that persisted to adulthood, as follows. As compared with neurosurgical controls, kindled kittens exhibited slow-wave sleep (SWS) and REM sleep insomnia at least 1 year after kindling and 1-5 months after convulsions, regardless of postictal recording delay. Sleep and arousal defects in kindled kittens were similar to but more pronounced than those in kindled adult cats, possibly because kittens spontaneously became epileptic. Detection of postkindling SWS insomnia could be masked by brief scoring epochs (less than the preferred 1-min epoch for cats); recurrent behavioral arousals after kindling frequently aborted 1-min SWS epochs but often did not interrupt 30-s SWS epochs (based on 1-min vs. 30-s minimum duration scoring criteria). Detection of postkindling REM sleep insomnia could be masked in kittens with alternating patterns of REM loss and REM rebound; all these kittens showed periodic bouts of REM onset from waking after kindling. Different data collection and analysis procedures influence detection of sleep and arousal disorders in amygdala-kindled cats when replication of findings is attempted. We conclude that these differences explain some controversies regarding the nature and prevalence of sleep disturbances in the kindling literature in temporal lobe epilepsy (TLE).
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PMID:Ontogeny of feline temporal lobe epilepsy. III: Spontaneous sleep and arousal disorders in amygdala-kindled kittens. 798 23

Stress is commonly believed to precipitate seizures in some patients with epilepsy, but direct examination of this assumption is problematic because of the difficulty in defining vague factors such as 'emotional stress'. Using a questionnaire, we have recorded seizure frequency during the 1991 Persian Gulf war, when Israelis were under stress from the threat of Scud missile attacks, in 100 consecutive adult patients with epilepsy. Increased frequency of seizures was reported by eight patients. These were younger than the other patients, the majority showed generalized epileptic EEG activity and all had generalized seizures (secondarily generalized in four). Only four had seizures directly related to the sounding of an alarm and in the others, non-compliance, being off medication at the time and disturbed sleep were probable contributory factors. We conclude that, in this series, epilepsy control was only weakly affected by an acute external emotional stress factor.
Seizure 1994 Jun
PMID:Stress and epilepsy: the Gulf war experience. 808 40

Seizure patients often complain of sleepiness or disturbed sleep. Although susceptible of medication effect, the multiple sleep latency test (MSLT) may quantify daytime sleepiness and help to establish whether qualitative sleep disturbance accompanies epilepsy. In order to measure daytime sleepiness in epilepsy patients, 30 patients with newly diagnosed or presently untreated complex partial seizures had MSLT after an overnight sleep EEG that showed no sleep deprivation or nocturnal seizures. Four 20-minute naps were undertaken at 09:00, 11:00, 13:00, and 15:00, and sleep latency was recorded along with 8 channels of EEG. Twenty of 30 seizure patients reported subjective sleepiness. Eight patients had average sleep latencies less than 8 minutes, and 3 had latencies less than 5 minutes. No sleep onset REM or respiratory disturbance was noted. Twenty-five patients had EEG abnormalities but none had ictal seizures. Right temporal epileptiform activity correlated with sleepiness. MSLT may quantify sleepiness in epilepsy patients, which is common but may be subjective or psychophysiological. Some patients with partial seizures have persistent daytime sleepiness independent of medication, possibly related to residual medication effects or non-specific effect of their epileptogenic foci.
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PMID:Multiple sleep latency tests in epilepsy. 819 89


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