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

Sleep disorders in childhood are a common phenomenon. A highly differenciated diagnostic effort is required as sleep in children is extremely variable between individuals, undergoes a constant natural development and depends of cultural influences on sleep behavior. The pathogenesis is predominantly due to environmental variables, especially to the child-parent interaction. Besides somatic diseases, as Sleep Related Breathing Disorders, Restless legs syndrome and nocturnal seizures play an etiologic role. Psychological and somatic factors in the development of sleep disorders have in common that they exercise a serious negative impact on cognitive daytime functioning and behavior. In this paper the interdependence of somatic and psychological factors and the relations between disturbed nighttime sleep and impaired daytime functioning will be discussed. Especially in Attention-Deficit Hyperactivity Disorder these relations can be demonstrated. Conclusions are drawn for a specific, stepwise diagnostic approach in children's sleep disorders.
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PMID:[Differential diagnostic correlations of sleep and attention disorders in childhood--comorbid psychological and organic illnesses]. 1500 87

Frontal lobe epilepsy is poorly understood and often unrecognized by health care workers caring for children. We sought to better characterize frontal lobe epilepsy in childhood and help delineate this condition from other nonepileptic events. We reviewed pediatric patients admitted to the Comprehensive Epilepsy Program at the University of Alberta Hospitals with a proven diagnosis of frontal lobe epilepsy. Twenty-two patients, 13 males and 9 females, were studied. Age of onset was variable from 10 months to 16 years (mean 7.5 years). Seizures were brief (30 seconds to 2 minutes), stereotypic, nocturnal (17/21), and frequent (3-22/night). Clinical features included explosive onset, screaming, agitation, stiffening, kicking or bicycling of the legs, and incontinence. The diagnosis of frontal lobe epilepsy was not made in any child before referral. The referring diagnosis was sleep disturbance (10), psychiatric problems (6), or other seizure types (6). Interictal electroencephalogram was usually normal (18/21). Long-term video electroencephalographic monitoring demonstrated frontal (9) or bifrontal (13) epileptic discharges. Magnetic resonance imaging was normal in most patients (18/21). Seizure control was difficult, with only half (11/21) the patients being controlled on medication. Three intractable patients went on to epilepsy surgery and became seizure-free. Frontal lobe epilepsy in childhood is a distinct epilepsy syndrome with characteristic features. The seizures are brief, stereotypic, nocturnal, and frequent. Electroencephalogram and magnetic resonance imaging are usually normal. The condition is often misdiagnosed as a sleep disorder or psychiatric problem. Seizures are difficult to control but may respond to carbamazepine, valproic acid, or epilepsy surgery.
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PMID:Frontal lobe epilepsy in childhood. 1503 98

The aim of the present study was to verify the clinical efficacy of melatonin (MLT) in children, adolescents and young adults with wake-sleep disorder and mental retardation, most of them on chronic anticonvulsant therapy for epileptic seizures, by means of a randomized, double-blind, placebo-controlled cross-over trial. Twenty-five patients (16 males, nine females), aged from 3.6 to 26 years (mean 10.5 years), all affected with mental retardation mostly with epileptic seizures, were randomized to oral synthetic fast-release MLT or placebo. Melatonin was initiated at the daily dose of 3 mg, at nocturnal bedtime. In case of inefficacy, MLT dose could be titrated up to 9 mg the following 2 weeks at increments of 3 mg/week, unless the patient was unable to tolerate it. The analysis of all the sleep logs disclosed a significant treatment effect of melatonin on sleep latency (P = 0.019). Melatonin was well tolerated in all patients and no side effects were reported. In conclusion, our study supports the efficacy of MLT in young patients with mental disabilities and epileptic seizures in improving the wake-sleep disorders such as time to fall asleep. Overall, MLT appeared to influence the seizure frequency poorly, though there may be occasional seizure worsening or improving. Such a dual effect requires further studies in young epileptic patients.
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PMID:Melatonin in wake-sleep disorders in children, adolescents and young adults with mental retardation with or without epilepsy: a double-blind, cross-over, placebo-controlled trial. 1527 98

Neural generators related to different sleep components have different effects on seizure discharge. These sleep-related systems can provoke seizure discharge propagation during nonrapid eye movement (NREM) sleep and can suppress propagation during REM sleep. Experimental manipulations of discrete physiological components were conducted in feline epilepsy models, mostly in the systemic penicillin epilepsy model of primary generalized epilepsy and the amygdala kindling model of the localization-related seizure disorder, temporal lobe epilepsy. The sleep-wake state distribution of seizures was quantified before and after discrete lesions, systemic and localized drug administration, and/or photic stimulation, as well as in relation to microdialysis of norepinephrine. We found that (1) neural generators of synchronous EEG oscillations--including tonic background slow waves and phasic "arousal" events (sleep EEG transients such as sleep spindles and k-complexes)--combine to promote electrographic seizure propagation during NREM and drowsiness, and antigravity muscle tone permits seizure-related movement; (2) neural generators of asynchronous neuronal discharge patterns reduce electrographic seizures during alert waking and REM sleep, and skeletal motor paralysis blocks seizure-related movement during REM; (3) there are a number of similarities between amygdala-kindled kittens and children with Landau-Kleffner Syndrome (LKS) that suggest a link among seizures, sleep disorders, and behavioral abnormalities/regression.
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PMID:Sleep and arousal mechanisms in experimental epilepsy: epileptic components of NREM and antiepileptic components of REM sleep. 1536 67

The purpose of this review article is to describe the clinical data linking autism with sleep and epilepsy and to discuss the impact of treating sleep disorders in children with autism either with or without coexisting epileptic seizures. Studies are presented to support the view that sleep is abnormal in individuals with autistic spectrum disorders. Epilepsy and sleep have reciprocal relationships, with sleep facilitating seizures and seizures adversely affecting sleep architecture. The hypothesis put forth is that identifying and treating sleep disorders, which are potentially caused by or contributed to by autism, may impact favorably on seizure control and on daytime behavior. The article concludes with some practical suggestions for the evaluation and treatment of sleep disorders in this population of children with autism.
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PMID:Sleep disorders, epilepsy, and autism. 1536 68

In recent years, sleep medicine has become a rapidly advancing field filled with exciting new discoveries. Many sleep disorders are diagnosed by clinical history alone. Sleep disorders such as sleep apnea, narcolepsy, periodic limb movement disorder, parasomnias, and nocturnal seizures usually require evaluation in the sleep laboratory. Sleep studies are used for diagnostic purposes, to assess disease severity, and to evaluate treatment efficacy. Sleep testing should be tailored to answer the specific clinical question at hand. This article reviews the techniques most commonly performed in the sleep laboratory and their indications, interpretation, and limitations. These include the polysomnogram, the multiple sleep latency test, and the maintenance of wakefulness test. The accurate interpretation of these studies requires a comprehensive sleep and medical history.
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PMID:The use of sleep studies in neurological practice. 1544 17

As a subset of epilepsy, nocturnal seizures amplify one of the major problems of epilepsy in general: episodes are less likely to be directly witnessed than daytime seizures, and therefore diagnosis and characterization are more difficult. As a sleep problem, nocturnal seizures are not benign, and the resulting sleep disruption can cause daytime somnolence and concentration difficulty. This article outlines three major topics in nocturnal seizures: differential diagnosis (distinguishing between seizures and parasomnias), the effects of nocturnal seizures on sleep structure, and specific syndromes of primarily or exclusively nocturnal seizures.
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PMID:Nocturnal seizures. 1544 22

The relationship of sleep and epilepsy demonstrates the delicate association of brain physiology and dysfunction. Sleep affects the distribution and frequency of epileptiform discharges in humans and influences the rate of kindling in animals. Epileptic discharges, on the other hand, alter sleep regulation and provoke sleep disruption. This effect on sleep appears to carry over to sleep complaints in patients with epilepsy. Individuals with epilepsy frequently complain of symptoms suggestive of disturbed sleep, such as excessive daytime sleepiness, insomnia, or with more subtle complaints such as an increase in seizure frequency. More commonly, these symptoms indicate an underlying sleep disorder rather than the effect of epilepsy or medication on sleep. Clinicians must be able to identify and differentiate between potential sleep disorders and sleep dysfunction related to epilepsy and direct therapy to improve the patient's symptoms. The reciprocal relationship of sleep and epilepsy and the management of sleep complaints in the patient with epilepsy will be reviewed.
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PMID:Sleep and epilepsy. 1544 23

We report a randomized, double-blind, controlled, crossover trial investigating the response to oral melatonin using two dose regimens in patients with sleep disorders associated with tuberous sclerosis complex. Eight outpatients with tuberous sclerosis complex and sleep disorder received either 5 or 10 mg of melatonin. Sleep latency, total sleep time, number of awakenings, and seizure frequency were recorded in sleep and seizure diaries. No evidence of a dose effect between 5 and 10 mg was seen with respect to any outcome measure. (The 5 mg results are given first: sleep latency, 86 and 76 minutes; total sleep time, 8 hours, 57 minutes and 9 hours, 4 minutes; and sleep fragmentation, 0.8 and 1.0). This study might have missed a small beneficial effect of 10 mg melatonin. We propose that an initial trial of 5 mg melatonin is worth considering in patients with tuberous sclerosis complex and sleep disorder.
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PMID:Effect of melatonin dosage on sleep disorder in tuberous sclerosis complex. 1579 28

Telemetric EEG recording plays a crucial role in the neurological characterization of various transgenic mouse models giving valuable information about epilepsies and sleep disorders in humans. In the past different experimental approaches have been described using tethered systems and jacket systems containing recorders. A main disadvantage of these is their sometimes unphysiological, restraining character. Telemetric EEG recording overcomes most of these disadvantages and allows precise and highly sensitive measurement under various physiological and pathophysiological conditions and different stages of consciousness, as during seizure activity and different sleep stages. Here we present the first contiguous, detailed description of a successful and quick technique for intraperitoneal implantation or subcutaneous pouch implantation of a radiofrequency transmitter in mice and subsequent lead placement in both epidural and deep intracerebral position. Preoperative preparation of the mice, suitable anesthesia, as well as postoperative treatment including pain management are described in detail to provide optimal postoperative recovery. Finally, we display examples of electrocorticograms and deep intracerebral recordings, present strategies to maximize signal-to-noise ratio, paying special attention to major pitfalls and possible artefacts occurring in telemetric EEG recording in mice.
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PMID:Electrocorticographic and deep intracerebral EEG recording in mice using a telemetry system. 1579 69


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