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Query: UMLS:C0238111 (
Lennox-Gastaut syndrome
)
861
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Non-rapid eye movement (NREM) sleep contains periods of arousal instability (cyclic alternating pattern or
CAP
) and periods of arousal stability (non-
CAP
). During
CAP
, arousal oscillates between higher (phase A) and lower (phase B) levels of activation. We evaluated the relationship between
CAP
and the occurrence of epileptic events, i.e. clinical seizures and generalized interictal discharges, during sleep in 10 patients with
Lennox-Gastaut syndrome
(
LGS
). The macro- and microstructure of sleep of 10 attended overnight polysomnograms were analyzed. Compared with 10 age- and gender-matched controls, patients with
LGS
had significantly less stage 2 and REM sleep and higher amounts of
CAP
rate (68% vs. 33%; P<0.0001). The number of generalized polyspike bursts per hour of sleep was highest in slow wave sleep (226.5+/-57.6) and lowest in REM sleep (3.9+/-1.5). The polyspike burst frequency was significantly greater (P<0.017) during
CAP
(213.2+/-60.1) than during non-
CAP
(100.3+/-40), and within
CAP
, generalized polyspikes occurred more often (P=0.005) during phase A (461.1+/-127.2) than during phase B (6.1+/-1.9). The total amount of generalized polyspike bursts identified in NREM sleep correlated positively both with the number of A phases containing at least one generalized polyspike (P=0.005) and with the mean number of polyspikes within each of these A phases (P<0.0001). Nocturnal clinical seizures occurred in 8 of the 10 patients and showed a similar trend. We conclude from our results that
CAP
modulates the occurrence of both clinical seizures and generalized epileptic discharges in
LGS
by means of a gate-control mechanism: an independent spike generator is inhibited in phase B and non-
CAP
and bursts with its intrinsic activity in phase A.
...
PMID:Sleep in Lennox-Gastaut syndrome: the role of the cyclic alternating pattern (CAP) in the gate control of clinical seizures and generalized polyspikes. 1207 49