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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study was designed to assess the effects of behavioural treatment on seizure recurrence, on seizure precipitants, and on associated psychiatric disturbances in 22 adolescents and young adults (age range 16-32 years, male : female ratio 10 : 12) with juvenile myoclonic epilepsy (JME) who showed seizure relapses despite rational AED therapy. The neurological assessment and a systematic search for seizure precipitants preceded to the use of psychiatric interviews and rating scales for anxiety and depression. After a structured counselling aiming at the elimination of seizure precipitants, the patients were assigned to one of two treatment modalities (an antistress programme or an individual cognitive behavioural therapy). Structured counselling was associated with complete seizure control in eight patients. In other 14 subjects with uncontrolled seizures, the psychotherapeutic treatment had two types of effects. First, the patients' fears and other unadapted responses, in the form of anxiety states and/or insomnia were significantly decreased during behavioural treatment. Second, a significantly lower rate of relapses occurred during behavioural treatment than during the baseline period. The results encourage the use of adjunctive behavioural treatment methods in decreasing seizure frequency, seizure precipitants and some types of comorbid psychopathology in patients with JME.
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PMID:Adjunctive behavioural treatment in adolescents and young adults with juvenile myoclonic epilepsy. 1118 Oct 97

Sleep and epilepsy share a complex pathophysiological association. Juvenile myoclonic epilepsy (JME) is a common sleep-sensitive epilepsy in which the effect of seizures could have therapeutic implications in terms of sleep disturbances and seizure control. This study aimed to analyze the effect of epilepsy on sleep in patients with JME. Fifty patients on valproic acid (VPA) monotherapy, and age- and gender-matched controls were recruited into this prospective, hospital-based, case-control study after informed consent and screening for inclusion criteria. They underwent a detailed clinical assessment, electroencephalogram (EEG) and neuroimaging, and were administered validated sleep questionnaires, which included the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and NIMHANS Sleep Disorders Questionnaire. The patient and control groups had identical numbers of males and females (M: F=22: 28), without any significant difference in the age and body mass index (BMI). The clinical profile of JME was similar to published literature while the prevalence of EEG abnormalities was less compared to similar studies. The mean ESS and PSQI scores and the number of subjects with abnormal scores on one or both questionnaires were significantly more in patients. Patients had a higher prevalence of sleep disturbances, insomnia and excessive daytime somnolence. No significant seizure- or treatment-related factors influencing sleep could be identified. This study, the first of its kind, revealed that patients with JME have significant sleep disturbances characterized by excessive daytime sleepiness and disturbed night sleep, despite adequate medications and good seizure control. The role of VPA in the genesis of these symptoms needs clarification.
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PMID:Sleep disturbances in juvenile myoclonic epilepsy: a sleep questionnaire-based study. 2236 52