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

Patients with epilepsy commonly complain of daytime sleepiness and poor sleep quality. These problems are frequently attributed to antiepileptic drugs and seizures. Antiepileptic drugs and seizures have effects on sleep architecture often leading to daytime sleepiness. However, sleep symptoms may also be caused by poor sleep hygiene and primary sleep disorders. Primary sleep disorders should be suspected in patients with persistent daytime sleepiness, particularly those on AED monotherapy or with low serum drug concentrations and well-controlled seizures. Treatment of sleep disorders and improved sleep hygiene may improve seizure control and quality of life.
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PMID:Sleep complaints and epilepsy: the role of seizures, antiepileptic drugs and sleep disorders. 1248 82

Quality sleep is essential for patients with epilepsy, but this aspect of their treatment is frequently overlooked. Sleep disturbance can result in daytime drowsiness, worsening memory, and deteriorating seizure control. In a few patients, recognition and treatment of a coexisting sleep disorder can make the difference between complete seizure control and refractory epilepsy. Sleep has effects on interictal epileptiform discharges, with particular implications for diagnostic studies. Sleep disorders can coexist with epilepsy, leading to errors in diagnosis and worsening of seizures. Some specific syndromes demonstrate unique properties related to sleep. Seizures themselves disrupt sleep, even when occurring during the day, with the potential for persistent drowsiness and, perhaps, further memory dysfunction. Finally, most patients with epilepsy are treated with anticonvulsant drugs, some of which can have adverse (or beneficial) effects on sleep.
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PMID:Sleep and epilepsy. 1252 57

Sleep is important for the general health of all, but is particularly essential for individuals with epilepsy. In these patients, a complex relationship exists between seizures and sleep, and both must be considered for optimal care. In this review, recent advances in the field of epilepsy and sleep are considered. These include sleep disorders with a specific relationship to epilepsy, the influences of sleep and sleep deprivation on interictal epileptiform discharges, detrimental effects of seizures on sleep, and the effects (good and bad) of epilepsy treatments on sleep.
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PMID:Sleep-related epilepsy. 1258 47

The interrelationship of sleep and epilepsy is described. Seizures and their treatment, including antiepileptic medications, may affect sleep. In turn, sleep disorders may influence seizure control and contribute to daytime sleepiness in epilepsy patients. Parasomnias and other sleep-related disorders may mimic epileptic seizures, although the history and video-EEG polysomnography are often useful in distinguishing these events. The treatment of epilepsy patients with sleep disorders or sleep complaints, such as sleepiness or insomnia, is discussed. Diagnosis and treatment of coexisting sleep disorders may improve not only daytime sleepiness, but also seizure control. Sedating AEDs may benefit epilepsy patients with insomnia, and stimulating AEDs may benefit epilepsy patients with daytime sleepiness.
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PMID:Treatment of sleep disorders in epilepsy. 1260 19

Seizures are common and are treated in all branches of medicine. Approximately 10% of the population will have one or more seizures during their lifetime. Seizures are symptoms that occur in acute illness, ie, provoked seizures, or in epilepsy, ie, unprovoked seizures. Epilepsy is any disorder in which spontaneous recurrence of unprovoked seizures is the main symptom. It is a common chronic neurologic disorder and affects 1% to 3% of the population. Classification of seizure type is important because it enables identification of the region of the brain where the seizure originated and guides initial diagnostic testing. Classification of epilepsy syndrome, rather than only type of seizure, is more important. Epilepsy syndromes are defined by many factors, including type of seizures, age at onset of seizures, family history of seizures, and findings at physical examination, electroencephalography (EEG), and neurologic imaging studies. Identifying the epilepsy syndrome provides insight into natural history, prognosis, diagnostic testing, and therapy of the disorder and facilitates communication between health care professionals. Understanding seizure type provides useful information even when the epilepsy syndrome cannot be classified. Many sudden events are easily confused with seizures, in particular, pseudoseizures, syncope, migraine, cerebrovascular disease, movement disorders, and sleep disorders. In most cases a detailed history and physical examination concentrated on the details of the event, and results of routine EEG and magnetic resonance imaging can aid in determination of which events are seizures. Video EEG monitoring is occasionally necessary to capture events to enable definitive determination of whether they are seizures and to further characterize them. Provoked seizures are treated with relief of the provoking factor. Antiepileptic drugs (AEDs) are not indicated. However, AEDs may be required to treat unprovoked seizures of new onset in patients at high risk for seizure recurrence or when a second seizure can have devastating psychosocial effects. High risk for recurrence is present when there is a history of brain insult, an EEG demonstrates epileptiform abnormalities, and magnetic resonance images demonstrate a structural lesion. AED therapy is the standard treatment for epilepsy, ie, two or more seizures. Selection of the appropriate AED depends on type of seizure and epilepsy present, and individual drug characteristics, including pharmacokinetics, side effects, dosing interval, and cost. All available AEDs except ethosuximide are effective as adjunctive therapy, and most are effective as initial monotherapy for partial seizures. Generalized seizures preferentially respond to valproate, lamotrigine, and topiramate, among other drugs. If trials of more than two AEDs do not control seizures, additional AEDs are unlikely to be effective, and the patient should be referred to an epilepsy center, where other treatment options, in particular, epilepsy surgery, can be offered. Epilepsy surgery renders 60% to 70% of patients with temporal lobe epilepsy free of disabling seizures.
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PMID:Epilepsy. 1283 66

Good-quality sleep is an important and frequently overlooked component of general health, but it is particularly essential to patients with epilepsy. Their sleep can be affected by seizures, concurrent sleep disorders and seizure treatment. Worsening sleep can result not only in poor daytime functioning but also potentially in worsening epilepsy. The effects of antiepileptic drugs (AEDs) on sleep are of particular concern. Some agents have detrimental effects on sleep, particularly benzodiazepines and barbiturates but also phenytoin and, possibly, carbamazepine. Others, especially gabapentin, seem to actually improve sleep quality. Much research in this area is confounded by the effects of seizures and concurrent conditions on sleep, making it difficult to isolate the direct effects of AEDs on sleep. But because AEDs have independent effects on sleep quality, the choice of an appropriate agent not only determines whether seizures are completely controlled but also whether the patient performs optimally on a daily basis.
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PMID:Effects of antiepileptic drugs on sleep structure : are all drugs equal? 1287 55

The objective of this study was to assess the utility of electroencephalography (EEG) in the evaluation of common neurologic conditions in children. The EEG recordings of 534 consecutive children (aged < 20 years) were prospectively read by a certified pediatric neurologist. Common diagnostic indications included the following: clinical seizures (33.8%), definite epilepsy (31.2%), attention-deficit hyperactivity disorder (ADHD) (9.1%), headache (8%), syncope (3.5%), learning disabilities (2%), tic disorders (1.4%), and sleep disorders (1.1%). Overall, 63.8% of EEG records were normal, slowing background activity was noted in 6.1%, ADHD was noted in 35.3% (definite epilepsy), and epileptiform activity was noted in 37.1% of the cases of definite epilepsy and 13.2% of the clinically suspected cases. Epileptiform activity was rarely found in the patients without epilepsy. All EEG records of children with syncope (n = 19) and headache (n = 43) were normal. These findings indicate that although EEG plays an important diagnostic role in epilepsy, interictal EEG is being overused during evaluation of various neurologic disorders in children, and a normal EEG is highly predictable in children with nonepileptic conditions.
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PMID:Utility of electroencephalography in the evaluation of common neurologic conditions in children. 1288 73

gamma-Aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the central nervous system. GABA is converted from glutamic acid by the action of glutamic acid decarboxylase (GAD) of which two isoforms exist GAD65 and GAD67. GABA then is broken down, both within the cell and in the synaptic cleft by GABA transaminase to form succinic semialdehyde. In turn, succinic semialdehyde is converted either to succinic acid by succinic semialdehyde dehydrogenase or into gamma-hydroxybutyric acid (GHB) by succinic semialdehyde reductase. Because GABA modulates the majority of inhibition that is ongoing in the brain, perturbations in GABAergic inhibition have the potential to result in seizures. Therefore, the most common disorder in which GABA is targeted as a treatment is epilepsy. However, other disorders such as psychiatric disease, spasticity, and stiff-person syndrome all have been related to disorders of GABAergic function in the brain. This review covers the roles of GABAergic neurotransmission in epilepsy, anxiety disorders, schizophrenia, stiff-person syndrome, and premenstrual dysphoric disorder. In the final section of this review, the GABA metabolite GHB is discussed in terms of its physiological significance and its role in epilepsy, sleep disorders, drug and alcohol addiction, and an inborn error of GABA metabolism, succinic semialdehyde dehydrogenase deficiency.
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PMID:GABA, gamma-hydroxybutyric acid, and neurological disease. 1289 48

We present a patient with spells of loss of awareness in which the initial diagnostic consideration was partial epilepsy. The patient underwent video-EEG long-term monitoring which raised suspicion of nonepileptic events, but could not exclude simple partial seizures. A failed therapeutic trial with antiepileptic medication and adverse events prompted reevaluation of the case. Sleep studies, including polysomnography and multiple sleep latency testing (MSLT), confirmed a sleep disorder, i.e., narcolepsy, which responded to specific therapy with resolution of the spells.
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PMID:Sleep disorders: a sometimes forgotten cause of nonepileptic spells. 1469 21

The objective of this study was to evaluate sleep macrostructure and sleep disturbance in a group of 39 patients with temporal lobe epilepsy (TLE). Patients completed questionnaires to evaluate their sleep and subjective daytime sleepiness (Epworth Sleepiness Scale [ESS]) and undergone Polysomnography and Multiple Sleep Latency Test (MSLT). Daytime sleepiness was the most frequent complaint (85%), followed by wakefulness during sleep, history of seizures during sleep (75%) and initial insomnia (26%). Parasomnias (67%), obstructive sleep apneas (13%), restless legs syndrome (15%) and periodic limb movements (5%) were the most frequent sleep disorders. The most frequent changes of sleep patterns were: sleep architecture fragmentation (100%), decreased amount of REM sleep (92%) and increase in time awake after sleep onset (77%). There were significative correlations between the ESS and the MSLT (p<0,05). In conclusion, TLE patients have fragmented sleep with increased sleep stages shifts, increased number of awakenings and in time awake after sleep onset. REM sleep was decreased. Daytime sleepiness was the most frequent complaint in TLE patients.
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PMID:[Sleep disorders in temporal lobe epilepsy]. 1476 2


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