The importance of the clinical context in EEG interpretation was highlighted by a study 6 of EEGs recorded during sleep in people who did not have epilepsy. When EEGs were performed after a period of sleep deprivation, 15 (52%) included IEDs, independent of the duration or depth of sleep during the test, showing that sleep deprivation has its own effect on IEDs. This study shows the value of overnight EEGs, especially if daytime EEGs are normal.Ī retrospective report by Fountain and coworkers 5 looked at the effect of sleep deprivation on the EEGs of 29 epilepsy patients whose routine EEGs had not shown any IEDs, even if that EEG included a period of sleep. There was high concordance with the site of seizure onset. All 24 patients showed IEDs in the overnight studies, versus only 11 in the daytime studies. In a study of 24 patients with refractory temporal lobe epilepsy, Malow and colleagues 4 compared routine daytime EEGs with overnight EEG recordings. Recent studies have confirmed and refined this knowledge. It has been known for decades that EEGs performed during sleep or with sleep deprivation are more likely than routine EEGs to show interictal epileptiform discharges (IEDs). 3 reviewed the circadian distribution of ictal and interictal events.Įffects of sleep on interictal epileptiform activity Other reviews of these interactions between sleep and epilepsy have been published for adults 1 and children. Doctors have often overlooked sleep disturbances in patients with epilepsy, but it is now clear that they may contribute to decreased daytime functioning and increased seizure activity. Sleep disorders in patients with epilepsy: Sleep disorders such as sleep apnea exacerbate seizures.Effects of seizures and antiepileptic drugs on sleep structure: Seizures can disrupt sleep structure, particularly REM sleep.Some of them present problems of diagnosis. Specific syndromes of sleep and epilepsy: Many varied epilepsy syndromes are related to sleep.REM sleep, however, seems to suppress seizures. Effects of sleep and sleep deprivation on the occurrence of seizures: Sleep increases certain seizure types and the rate of generalization of partial seizures.Effects of sleep on interictal epileptiform activity: Sleepparticularly deep non-REM sleep increases interictal epileptiform activity.Research is making the relationship clearer: Understanding the ways that each influences the other can be important for patient care. Sleep and epilepsy affect each other in complicated ways.
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