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

Disorders of sleep belong to the most frequent troubles. A lot of different factors may contribute to the pathogenesis of sleep disorders. Modern sleep research has opened important views into the structure of sleep and the pathophysiology of sleep disorders. In a narrower sense sleep disorders mean a deficiency of sleep (hyposomnia). This may concern the induction of sleep or its maintenance. Sleep disorders without underlying disease may be differentiated from those caused by different diseases. Hypersomnia may occur as a symptom of various cerebral dysfunctions and processes, as an episodic disorder (Kleine-Levin-syndrome) or as a part of the Pickwick-syndrome. In narcolepsy characteristic symptoms are sleep attacks, kataplexy (emotionally induced loss of muscle tone) and transient pareses during awakening. Disturbances linked with sleep are snoring, somnambulism, speaking and grinding of the teeth during sleep and nocturnal enuresis. They may constitute idiopathic disorders. On the other hand, there may be similarities between epileptic phenomena and these disorders. Some epilepsies demonstrate relations to the rhythm of sleep and wakefulness which become evident in the manifestation of seizures and epileptiform EEG activity at certain stages of vigilance.
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PMID:[Disorders of the sleep-wakefulness function]. 26 25

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

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

Obstructive sleep apnoea was first brought to prominence by Henri Gastaut, a French epileptologist. Since that time the interface between epilepsy and sleep disorders has received less attention than might be justified, recognizing that sleep deprivation is a poignant provocateur for seizures. Sleep deprivation is often used as a diagnostic procedure during electroencephalography (EEG) when waking EEG has failed to demonstrate abnormality. Patients referred to an outpatient neurological clinic for evaluation of possible seizures in whom sleep disorder was suspected, either due to snoring during the EEG or based on history, were evaluated with all-night diagnostic polysomnography (PSG) and appropriate intervention administered as indicated. Patient and seizure demography, sleep disorder and response to therapy were reviewed and the interface explored. Fifty patients aged between 10 and 83 years underwent PSG. Approximately half were diagnosed with epilepsy and almost three-quarters had sleep disorders sufficiently intrusive to require therapy (either continuous positive air pressure (CPAP) or medication). With co-existence of epilepsy and sleep disorders, proper management of sleep disorders provided significant benefit for seizure control. Snoring during EEG recordings could alert to the possibility of a sleep disorder even with epilepsy diagnosed. Where both epilepsy and sleep disorder coexist appropriate management of the sleep disorder improves control of the epilepsy.
Seizure 1999 Apr
PMID:Interface of epilepsy and sleep disorders. 1022 1

The aim of the study was to assess sleep-wake habits and disorders and excessive daytime sleepiness (EDS) in an unselected outpatient epilepsy population. Sleep-wake habits and presence of sleep disorders were assessed by means of a clinical interview and a standard questionnaire in 100 consecutive patients with epilepsy and 90 controls. The questionnaire includes three validated instruments: the Epworth Sleepiness Scale (ESS) for EDS, SA-SDQ for sleep apnea (SA), and the Ullanlinna Narcolepsy Scale (UNS) for narcolepsy. Sleep complaints were reported by 30% of epilepsy patients compared to 10% of controls (p=0.001). The average total sleep time was similar in both groups. Insufficient sleep times were suspected in 24% of patients and 33% of controls. Sleep maintenance insomnia was more frequent in epilepsy patients (52% vs. 38%, p=0.06), whereas nightmares (6% vs. 16%, p=0.04) and bruxism (10% vs. 19%, p=0.07) were more frequent in controls. Sleep onset insomnia (34% vs. 28%), EDS (ESS >or=10, 19% vs. 14%), SA (9% vs. 3%), restless legs symptoms (RL-symptoms, 18% vs. 12%) and most parasomnias were similarly frequent in both groups. In a stepwise logistic regression model loud snoring and RL-symptoms were found to be the only independent predictors of EDS in epilepsy patients. In conclusion, sleep-wake habits and the frequency of most sleep disorders are similar in non-selected epilepsy patients as compared to controls. In epilepsy patients, EDS was predicted by a history of loud snoring and RL-symptoms but not by SA or epilepsy-related variables (including type of epilepsy, frequency of seizures, and number of antiepileptic drugs).
Seizure 2006 Jul
PMID:Sleep-wake habits and disorders in a series of 100 adult epilepsy patients--a prospective study. 1654 7

Patients with epilepsy were reported to have concomitant sleep apnea, but it has been rarely linked to the epilepsy itself. We present a case of a 28-year-old, obese man with secondary medically resistant partial complex epilepsy due to a brain trauma, with progressive snoring, and sleep agitation, apneas, and important daytime somnolence. It was noticed in the polysomnographic study that he had several sleep respiratory events, probably due both to the epileptic seizures and the sleep apnea syndrome as a co-morbidity. Apnea and epilepsy will be discussed. A careful video-EEG-polysomnography study is important in evaluating refractory epileptic patients and/or epileptic patients with snoring.
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PMID:Probable causal link between epilepsy and sleep apnea: case report. 1742 Aug 49

During a viewing of Disney's animated film Cinderella (1950), one author (AI) noticed a dog having nightmares with dream-enactment that strongly resembled RBD. This prompted a study in which all Disney classic full-length animated films and shorts were analyzed for other examples of RBD. Three additional dogs were found with presumed RBD in the classic films Lady and the Tramp (1955) and The Fox and the Hound (1981), and in the short Pluto's Judgment Day (1935). These dogs were elderly males who would pant, whine, snuffle, howl, laugh, paddle, kick, and propel themselves while dreaming that they were chasing someone or running away. In Lady and the Tramp the dog was also losing both his sense of smell and his memory, two associated features of human RBD. These four films were released before RBD was first formally described in humans and dogs. In addition, systematic viewing of the Disney films identified a broad range of sleep disorders, including nightmares, sleepwalking, sleep related seizures, disruptive snoring, excessive daytime sleepiness, insomnia and circadian rhythm sleep disorder. These sleep disorders were inserted as comic elements. The inclusion of a broad range of accurately depicted sleep disorders in these films indicates that the Disney screenwriters were astute observers of sleep and its disorders.
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PMID:REM sleep behavior disorder and other sleep disturbances in Disney animated films. 1751 93

Brain natriuretic peptide(BNP) and the N-terminal pro-brain natriuretic peptide (NTproBNP)are important cardiac biomarkers secreted by the heart in response to increased ventricular wall stress associated with heart failure. The aim of our case series was to prospectively evaluate the influence of vagus nerve stimulation (VNS) on the release of NTproBNP.Three children with medically refractory epilepsy and scheduled for implantation of the VNS device were included. Pre-implantation,NT-proBNP measurements were taken at two different occasions after seizure-free periods of at least three days. After implantation,NT-proBNP measurements were taken every 2 to 4 weeks, immediately before and immediately after up-regulation of the VNS. After VNS implantation, the pattern of NT-proBNP increase was consistent for all children. In a 12 year-old girl, NT-proBNP concentrations reached a maximum of an almost 10-fold increase. Thereafter, NTproBNP concentrations returned continuously to baseline. In a three year-old boy, NT-proBNP concentrations reached a maximum of an almost 7-fold increase, accompanied by manifestation of side effects(voice alterations, snoring).Thereafter, NT-proBNP concentrations decreased to almost 4-fold those at baseline. In an 8 year-old girl, NT-proBNP concentrations increased slightly without yet reaching a plateau. This case series suggests that NT-proBNP concentrations increase in response to VNS-induced autonomic influences involving endocrinological stress-response mechanisms typically associated with cardiac injury.Especially in patients with pre-existing cardiovascular dysfunction,measurement of NT-proBNP concentrations may help to identify patients with high baseline concentrations and possibly at greater risk for cardiac side effects.
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PMID:N-terminal pro-brain natriuretic peptide (NT-proBNP) release in children with vagus nerve stimulation. A prospective case series. 1858 Oct 38

This study sought to evaluate polysomnographic abnormalities in a cohort of 40 children with epilepsy who underwent a sleep study because of various sleep complaints. Retrospective analyses included polysomnographic variables, antiepileptic drugs, type of epilepsy, and seizure control. The subgroup with epilepsy and obstructive sleep apnea syndrome was compared with 11 children who manifested uncomplicated obstructive sleep apnea syndrome. Thirty-three patients (83%) exhibited snoring (42.5%), sleep-disordered breathing (obstructive hypoventilation, 12.5%; obstructive sleep apnea, 20%; and upper-airway resistance syndrome, 7.5%), or periodic limb movements of sleep (10%). Children with poor seizure control demonstrated significantly lower sleep efficiency, a higher arousal index, and a higher percentage of rapid-eye-movement sleep compared with children who were seizure-free or exhibited good seizure control. Patients with epilepsy and obstructive sleep apnea had significantly a higher body mass index, longer sleep latency, a higher arousal index, and a lower apnea-hypopnea index, but significantly more severe desaturation compared with patients with uncomplicated obstructive sleep apnea. A significant proportion of children with epilepsy referred for polysomnography with diverse sleep problems manifest sleep-disordered breathing, including obstructive sleep apnea syndrome.
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PMID:Spectrum of polysomnographic abnormalities in children with epilepsy. 1872 61

Sleep-related breathing disruptions in children with epilepsy are common and can range from primary snoring to obstructive sleep apnea. Untreated obstructive sleep apnea can lead to significant morbidity. This study aimed to identify factors associated with its occurrence and severity in children with epilepsy. Children with epilepsy and sleep disruption were evaluated with polysomnography and diagnosed with obstructive sleep apnea or primary snoring. Statistical analyses were done to identify differences within both the groups and among the subjects in the obstructive sleep apnea group. Uncontrolled epilepsy was a risk factor for obstructive sleep apnea (80%) compared with primary snoring (47%, P = .02). Obstructive index increased with increasing number of antiepileptic drugs. In children with epilepsy and disturbed sleep, obstructive sleep apnea is associated with uncontrolled epilepsy and is more severe with polytherapy use. Children with uncontrolled seizures on antiepileptic polytherapy should be routinely screened for obstructive sleep apnea.
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PMID:Obstructive sleep apnea and primary snoring in children with epilepsy. 2258 Sep 3


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