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

A case with vigilance level-dependent, nightly occurring, generalized, axial, tonic motor seizures without any ictal or interictal scalp electroencephalographic expression is presented. A pathological sleep pattern with many arousals, superficial sleep, and an interrelation between the seizures and the arousal episodes was demonstrated. An epileptic excitation discharge during the seizures was verified on the right cingular cortex by stereoencephalography. The physiopathogenesis and differential diagnostic problems in the interpretation of such cases as a sleep disorder or an epileptic mechanism are discussed.
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PMID:Vigilance level-dependent tonic seizures--epilepsy or sleep disorder? A case report. 664 48

Progressive sleep deficits accompanying the gradual development of a kindled seizure disorder in cats persist at least one month after kindling and correlate with subsequent seizure thresholds. These parallels between the two pathologies suggest the kindling of a sleep disorder which occurs in addition to, and may be a determinant of, the kindled seizure disorder.
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PMID:'Kindling' a sleep disorder: degree of sleep pathology predicts kindled seizure susceptibility in cats. 668 88

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

Sleep disorders were investigated in 40 children with tuberous sclerosis (TS) and compared with those found in non-disabled children and those reported in a mixed group with learning disabilities. Significantly higher levels of sleep disturbance were found in the TS group compared with both other groups. Within the TS group, current epilepsy and a high level of daytime behavioural disturbance were significantly associated with sleep disturbance, but pervasive developmental delay and high parental stress levels were not. Detailed study of the relationship between seizure activity and sleep disturbance in tuberous sclerosis is needed.
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PMID:Sleep disorder and epilepsy in children with tuberous sclerosis: a questionnaire-based study. 751 Jun 55

Benzodiazepines are the psychotropics most frequently prescribed despite an impressive reduction in use in the last 10 years. Their main pharmacodynamic effects (anxiolytic, sedative, anticonvulsive, muscle-relaxing, amnestic) are the basis for various therapeutic applications and indications. The most important differences among the variety of benzodiazepines are pharmacokinetic ones (elimination half-life, formation of pharmacologically active metabolites). Established indications are anxiety and sleep disorders, seizures, epilepsy, premedication and sedation in emergency medicine. In recent years it has also been proven to be effective in the treatment of panic disorder and catatonia. Among the side effects seen most frequently are impairments of cognitive and psychomotor function as well as rebound phenomena. Discussions have recently focused on the incidence of abuse and dependence as well as case reports on severe amnesia. Alternative medications like neuroleptics in low dosage and antidepressants seem to be predominantly unfavorable due to the fact that they are tolerated less well and sometimes have severe side effects. A clear-cut indication and time-limited prescription can reduce the number of benzodiazepine long-term users, and a comprehensive treatment concept must be the basis of rational prescription of benzodiazepines. The positive benefit-risk ratio as well as research perspectives [identification of receptor subtypes, development of highly selective ligands and partial (inverse) agonists] are reasons for assuming that the era of the benzodiazepines has not come to an end.
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PMID:[Current status of treatment with benzodiazepines]. 760 11

Amygdala-kindled kittens exhibit frequent epileptiform EEG transients, often in conjunction with phasic arousal events of sleep [k-complexes, pontogeniculo-occipital (PGO) waves, and/or sleep spindles]. In this study, paroxysmal microarousals occurred throughout the sleep-wake cycle after kindling, but were most frequent during seizure-prone states of slow-wave sleep (SWS) and the transition into rapid-eye-movement sleep (REM). Their incidence correlated with interictal sleep fragmentation as well as onset of spontaneous convulsions. Results could reflect transsynaptic kindling effects on brainstem and forebrain arousal mechanisms with which amygdala is reciprocally connected. Increased discharge rates of neural generators for normal EEG and behavioral arousal could disrupt sleep at some times and recruit epileptic neurons in the kindled focus to precipitate seizures at others. Alternatively, epileptiform EEG paroxysms were accompanied by subtle behavioral stereotypes (a head nod, limb elevation, eye twitch, lip smack, or a combination of these). Behavioral correlates were elements of partial kindled seizures, suggesting that paroxysmal microarousals may be subclinical seizures. Whether or not the microarousals are true seizures, our findings may link ictal onset and interictal sleep disorders to a subclinical paroxysmal arousal disorder and suggest a common epileptic mechanism.
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PMID:Paroxysmal microarousals in amygdala-kindled kittens: could they be subclinical seizures? 761 14

Overnight polysomnography was performed in 10 subjects with tuberous sclerosis (TS) and partial epilepsy in order to investigate the relationships between sleep organization, sleep disorders and epilepsy. Sleep architecture abnormalities were observed in 9 cases. Compared with ten healthy age-matched controls, the TS group showed a shorter total sleep time, a reduced sleep efficiency, a higher number of awakenings and stage transitions, an increased wake after sleep onset and stage 1 and a decreased REM sleep. Children with seizures showed a more disrupted sleep architecture compared with seizure-free children. Sleep disorders in TS were mainly due to sleep-related epileptic events and were more evident in children who showed large bifrontal or temporal tubers on MRI.
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PMID:Sleep disorders in tuberous sclerosis: a polysomnographic study. 776 64

Neuropsychological dysfunction in children and adults with epilepsy is common and has several possible interrelated causes, including the underlying pathophysiology, possible cerebral pathology, the effects of subclinical discharges, sleep disorders, status epilepticus and drug therapy. Of these factors the effects of subclinical discharges and those of medication are potentially remediable. In up to 50% of patients with subclinical epileptiform EEG discharges, these are associated with transitory cognitive impairment. When the discharges are focal, the cognitive deficits usually reflect the normal neuropsychological functions of the affected brain region. Most antiepileptic drugs, with the exception of the benzodiazepines (which themselves adversely affect cognition) and lamotrigine, do not suppress inter-ictal discharges. Although well-designed clinical trials of the effects of antiepileptic drugs are difficult to perform, there is convincing evidence that phenobarbitone and phenytoin cause cognitive impairment. Drugs which control both the seizures and inter-ictal discharges should improve cognitive function, provided the drugs themselves do not have a cognitive penalty. Lamotrigine provides effective control of both overt and subclinical seizures, without adversely affecting cognition.
Seizure 1994 Dec
PMID:Cognitive impairment--is it inevitable? 789 46

We identified seven patients with refractory partial epilepsy and sleep apnea. Treatment of the sleep apnea with nasal continuous positive airway pressure (CPAP), protriptyline, trazodone, acetazolamide, or tracheostomy reduced seizure frequency and severity in six patients. Success with CPAP depended largely on compliance. Four of five patients had a clear reduction in seizure frequency with the use of CPAP. Sleep apnea may exacerbate epilepsy by causing sleep disruption and deprivation, hypoxemia, and decreased cerebral blood flow. In epilepsy patients with risk factors (eg, obesity) or markers (eg, habitual snoring, daytime somnolence) for sleep apnea, a careful sleep history should be elicited and a polysomnogram obtained when indicated. Treatment of the sleep disorder can improve seizure control.
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PMID:Epilepsy and sleep apnea syndrome. 884 27

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


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