51
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Grigg-Damberger MM, Foldvary-Schaefer N. Diagnostic Yield of Sleep and Sleep Deprivation on the EEG in Epilepsy. Sleep Med Clin 2012. [DOI: 10.1016/j.jsmc.2011.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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52
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Sleep architecture impairment in epileptic children and putative role of anti epileptic drugs. Neurol Sci 2012; 34:57-62. [DOI: 10.1007/s10072-012-0971-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Accepted: 01/31/2012] [Indexed: 11/24/2022]
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53
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Hallböök T, Ji S, Maudsley S, Martin B. The effects of the ketogenic diet on behavior and cognition. Epilepsy Res 2011; 100:304-9. [PMID: 21872440 DOI: 10.1016/j.eplepsyres.2011.04.017] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2010] [Revised: 04/03/2011] [Accepted: 04/25/2011] [Indexed: 12/26/2022]
Abstract
Multiple forms of the ketogenic diet (KD) have been successfully used to treat drug-resistant epilepsy, however its mainstream use as a first-line therapy is still limited. Further investigation into its clinical efficacy as well as the molecular basis of activity is likely to assist in the reversal of any resistance to its implementation. In this review we shall attempt to elucidate the current state of experimental and clinical data concerning the neuroprotective and cognitive effects of the KD in both humans and animals. Generally, it has been shown by many research groups that effective implementation of KD exerts strong neuroprotective effects with respect to social behavior and cognition. We will also elucidate the role of KD in the interesting relationship between sleep, epilepsy and memory. Currently available evidence also indicates that, under appropriate control, and with further studies investigating any potential long-term side effects, the KD is also a relatively safe intervention, especially when compared to traditional anti-epileptic pharmacotherapeutics. In addition, due to its neuroprotective capacity, the KD may also hold potential benefit for the treatment of other neurological or neurodegenerative disorders.
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Affiliation(s)
- Tove Hallböök
- Queen Silvia Children's Hospital, Sahlgrenska University, Gothenburg, Sweden.
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54
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From sleep spindles of natural sleep to spike and wave discharges of typical absence seizures: is the hypothesis still valid? Pflugers Arch 2011; 463:201-12. [PMID: 21861061 PMCID: PMC3256322 DOI: 10.1007/s00424-011-1009-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 07/22/2011] [Accepted: 08/01/2011] [Indexed: 11/15/2022]
Abstract
The temporal coincidence of sleep spindles and spike-and-wave discharges (SWDs) in patients with idiopathic generalized epilepsies, together with the transformation of spindles into SWDs following intramuscular injection of the weak GABAA receptor (GABAAR) antagonist, penicillin, in an experimental model, brought about the view that SWDs may represent ‘perverted’ sleep spindles. Over the last 20 years, this hypothesis has received considerable support, in particular by in vitro studies of thalamic oscillations following pharmacological/genetic manipulations of GABAARs. However, from a critical appraisal of the evidence in absence epilepsy patients and well-established models of absence epilepsy it emerges that SWDs can occur as frequently during wakefulness as during sleep, with their preferential occurrence in either one of these behavioural states often being patient dependent. Moreover, whereas the EEG expression of both SWDs and sleep spindles requires the integrity of the entire cortico-thalamo-cortical network, SWDs initiates in cortex while sleep spindles in thalamus. Furthermore, the hypothesis of a reduction in GABAAR function across the entire cortico-thalamo-cortical network as the basis for the transformation of sleep spindles into SWDs is no longer tenable. In fact, while a decreased GABAAR function may be present in some cortical layers and in the reticular thalamic nucleus, both phasic and tonic GABAAR inhibitions of thalamo-cortical neurons are either unchanged or increased in this epileptic phenotype. In summary, these differences between SWDs and sleep spindles question the view that the EEG hallmark of absence seizures results from a transformation of this EEG oscillation of natural sleep.
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55
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Chan B, Cheong EYK, Ng SFG, Chan YC, Lee QU, Chan KY. Evaluation of sleep disturbances in children with epilepsy: a questionnaire-based case-control study. Epilepsy Behav 2011; 21:437-40. [PMID: 21704566 DOI: 10.1016/j.yebeh.2011.05.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 05/03/2011] [Accepted: 05/06/2011] [Indexed: 11/18/2022]
Abstract
Epilepsy is a chronic neurological disorder accompanied by a wide range of comorbid conditions that can adversely affect the quality of life of children. Sleep disturbances not only predispose children to mood, cognitive, and behavioral impairments, but also have a significant impact on physical health. The aim of this study was to evaluate sleep patterns among Chinese children with epilepsy and healthy subjects in Hong Kong, and examine the relationship between parent-reported sleep problems and specific epilepsy parameters. We conducted a cross-sectional, questionnaire-based, case-control study and included 63 children with epilepsy and 169 healthy children aged between 4 and 12 years. The Children's Sleep Habits Questionnaire (CSHQ) was used as an assessment tool. Our results indicated that children with epilepsy have similar sleep patterns but greater sleep disturbances compared with healthy subjects. Sleep problems should not be overlooked, and a comprehensive review of the sleep habits of this group of patients should be conducted.
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Affiliation(s)
- Bosco Chan
- Department of Pediatrics and Adolescent Medicine, Princess Margaret Hospital, Kowloon, Hong Kong.
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56
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Hylkema T, Petitiaux W, Vlaskamp C. Utility of Staff Training on Correcting Sleep Problems in People With Intellectual Disabilities Living in Residential Settings. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1741-1130.2011.00294.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Tejo Hylkema
- Rijksuniversiteit Groningen, Groningen
- Sleepcentre SEIN, Groningen
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57
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van Golde EGA, Gutter T, de Weerd AW. Sleep disturbances in people with epilepsy; prevalence, impact and treatment. Sleep Med Rev 2011; 15:357-68. [PMID: 21439869 DOI: 10.1016/j.smrv.2011.01.002] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 01/14/2011] [Accepted: 01/15/2011] [Indexed: 11/30/2022]
Abstract
The interaction between epilepsy and sleep is thoroughly studied and is very complex. This review focuses on prevalence, impact on quality of life and effects of treatment of sleep disorders on the course of epilepsy. Self-reported sleep disturbances in people with epilepsy are about twice as prevalent as in healthy controls. People with epilepsy with sleep disturbances have a significant impairment of quality of life compared to those with no sleep disturbances. In children with epilepsy, sleep problems may lead to detrimental effects on daytime behavior and cognition. Most is known about obstructive sleep apnea syndrome (OSAS). Co-morbidity of epilepsy and OSAS is shown to be far higher than expected by chance. Treatment of OSAS significantly improves seizure control in people with epilepsy. More studies on the prevalence of other sleep disorders in people with epilepsy and the effect of treatment are required. Reports on the effect of treatment for other sleep disorders are scarce and not unequivocal.
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Affiliation(s)
- Esther G A van Golde
- Department of Clinical Neurophysiology and Sleep Centre SEIN Zwolle, Dokter Denekampweg 20, 8025 BV Zwolle, The Netherlands.
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58
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Abstract
The relationship between specific epilepsy syndromes and particular sleep symptoms has not been well delineated. The authors' aim was to test the hypothesis that children with rolandic epilepsy exhibit more frequent sleep problems and daytime sleepiness compared with children without epilepsy. They compared parent-reported sleep behaviors of 43 children with rolandic epilepsy aged 6 to 16 years recruited from 5 US pediatric neurology centers with a historical reference and sleep clinic sample using the Child Sleep Habits Questionnaire. The authors compared the differences in mean frequency of sleep problems and patterns. Total Children's Sleep Habits Questionnaire scores were significantly higher (P < .001) in the rolandic epilepsy sample than reference. Parents of children with rolandic epilepsy reported a significantly shorter sleep duration (P < .006), more frequent parasomnias (P < .008), and increased daytime sleepiness (P < .001). Thus, parents of children with rolandic epilepsy reported more problematic sleep and daytime impairment compared with a reference sample of children.
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Affiliation(s)
- Shan S Tang
- Department of Clinical Neurosciences, Institute of Psychiatry, King's College London, London, UK
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59
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Parisi P, Bruni O, Pia Villa M, Verrotti A, Miano S, Luchetti A, Curatolo P. The relationship between sleep and epilepsy: the effect on cognitive functioning in children. Dev Med Child Neurol 2010; 52:805-10. [PMID: 20370812 DOI: 10.1111/j.1469-8749.2010.03662.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The purpose of this review was to examine the possible pathophysiological links between epilepsy, cognition, sleep macro- and microstructure, and sleep disorders to highlight the contributions and interactions of sleep and epilepsy on cognitive functioning in children with epilepsy. METHOD PubMed was used as the medical database source. No language restriction was placed on the literature searches, and citations of relevant studies in the paediatric age range (0-18 y) were checked. Studies including a mixed population but with a high percentage of children were also considered. RESULTS The searches identified 223 studies. One reviewer scanned these to eliminate obviously irrelevant studies. Three reviewers scanned the remaining 128 studies and their relevant citations. The review showed that several factors could account for the learning impairment in children with epilepsy: aetiology, electroencephalographic (EEG) discharges, and persistence and circadian distribution of seizures, etc. EEG discharges may affect cognition and sleep, even in the absence of clinical or subclinical seizures. The sleep deprivation and/or sleep disruption affect the neurophysiological and neurochemical mechanisms important for the memory-learning process, but also influence the expression of EEG discharges and seizures. Learning and memory consolidation can take place over extended periods, and sleep has been demonstrated to play a fundamental role in these processes through neuroplastic remodelling of neural networks. Epilepsy and EEG paroxysms may affect sleep structure, interfering with these physiological functions. INTERPRETATION Improvement in the long-term cognitive-behavioural prognosis of children with epilepsy requires both good sleep quality and good seizure control. The antiepileptic drug of choice should be the one that interferes least with sleep structure and has the best effect on sleep architecture--thus normalizing sleep instability, especially during non-rapid eye movement sleep.
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Affiliation(s)
- Pasquale Parisi
- Child Neurology and Sleep Paediatric Disorders Centre, II Faculty of Medicine, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
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60
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Nunes ML. Sleep and epilepsy in children: Clinical aspects and polysomnography. Epilepsy Res 2010; 89:121-5. [DOI: 10.1016/j.eplepsyres.2009.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Revised: 10/20/2009] [Accepted: 10/29/2009] [Indexed: 10/20/2022]
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61
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Ong LC, Yang WW, Wong SW, alSiddiq F, Khu YS. Sleep habits and disturbances in Malaysian children with epilepsy. J Paediatr Child Health 2010; 46:80-4. [PMID: 20105259 DOI: 10.1111/j.1440-1754.2009.01642.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To compare sleep habits and disturbances between Malaysian children with epilepsy and their siblings (age range 4-18 years) and to determine the factors associated with greater sleep disturbance. METHODS The Sleep Disturbance Scale for Children (SDSC) questionnaire was completed by the primary caregiver for 92 epileptic children (mean age 11.1 years, 50 male, 42 females) and their healthy siblings (mean age 11.1 years, 47 males, 45 females). Details of sleep arrangements and illness severity were obtained. Multiple regression analysis was used to determine factors associated with high Total SDSC scores in epileptic patients. RESULTS Compared with their siblings, epileptic children had significantly higher total SDSC score (difference between means 8.7, 95% confidence interval (CI) 6.4-11.1) and subscale scores in disorders of initiating and maintaining sleep (3.9, 95% CI 2.8-5.2), sleep-wake transition disorders (2.1, 95% CI 1.3-2.9), sleep-disordered breathing (0.7, 95% CI 0.3-1.1) and disorders of excessive sleepiness (1.5, 95% CI 0.6-2.4). Epileptic children had a higher prevalence of co-sleeping (73.7% vs 31.5%) and on more nights per week (difference between means 3, 95% CI 2.0-3.9) than their siblings. Higher Epilepsy Illness Severity scores were associated with higher total SDSC scores (P= 0.02). CONCLUSION Co-sleeping was highly prevalent in children with epilepsy, who also had more sleep disturbances (especially problems with initiating and maintaining sleep and sleep-wake transition disorders) than their siblings. Epilepsy severity contributed to the sleep disturbances. Evaluation of sleep problems should form part of the comprehensive care of children with severe epilepsy.
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Affiliation(s)
- Lai Choo Ong
- Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Kuala Lumpur, Malaysia.
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62
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Evaluation of sleep quality in patients with refractory seizures who undergo epilepsy surgery. Epilepsy Behav 2010; 17:120-3. [PMID: 20004148 DOI: 10.1016/j.yebeh.2009.11.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 11/11/2009] [Accepted: 11/16/2009] [Indexed: 11/20/2022]
Abstract
The aim of the study was to evaluate excessive daytime sleepiness and subjective sleep quality in patients who undergo epilepsy surgery for treatment of refractory partial seizures. Forty-eight patients were enrolled in this research study. All of them were evaluated 2 days before and 3 months after the surgery. Two questionnaires were used to assess daytime sleepiness (Epworth Sleepiness Scale [ESS]) and sleep quality (Pittsburgh Sleep Quality Index [PSQI]). Global PSQI was high (mean=5.65 SD=3.71) before the surgical procedure (P<0.001). PSQI evaluation revealed higher and statistically significant scores in three components as well as in the global score, when analyzed by predominance of daytime or nocturnal seizures. ESS and PSQI scores were also analyzed by gender, antiepileptic drug class, age, and seizure frequency, with no significant differences. We concluded that patients with partial recurrent seizures of temporal origin have poor subjective sleep quality that improves significantly after epilepsy surgery.
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63
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Parisi P, Moavero R, Verrotti A, Curatolo P. Attention deficit hyperactivity disorder in children with epilepsy. Brain Dev 2010; 32:10-6. [PMID: 19369016 DOI: 10.1016/j.braindev.2009.03.005] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 03/17/2009] [Accepted: 03/22/2009] [Indexed: 10/20/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is more frequent in children with epilepsy than in general pediatric population. Several factors may contribute to this comorbidity, including the underlying brain pathology, the chronic effects of seizures and of the epileptiform EEG discharges, and the effects of antiepileptic drugs. Symptoms of ADHD are more common in some specific types of epilepsies, such as frontal lobe epilepsy, childhood absence epilepsy and Rolandic epilepsy, and may antedate seizure onset in a significant proportion of cases. In epileptic children with symptoms of ADHD, treatment might become a challenge for child neurologists, who are forced to prescribe drugs combinations, to improve the long-term cognitive and behavioral prognosis. Treatment with psychotropic drugs can be initiated safely in most children with epilepsy and ADHD symptoms.
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Affiliation(s)
- Pasquale Parisi
- Department of Pediatrics - La Sapienza University of Rome, Rome, Italy
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64
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Gallop K, Wild D, Nixon A, Verdian L, Cramer JA. Impact of Lennox-Gastaut Syndrome (LGS) on health-related quality of life (HRQL) of patients and caregivers: Literature review. Seizure 2009; 18:554-8. [PMID: 19592271 DOI: 10.1016/j.seizure.2009.06.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Accepted: 06/05/2009] [Indexed: 11/18/2022] Open
Affiliation(s)
- Katy Gallop
- Oxford Outcomes Ltd, Seacourt Tower, West Way, Oxford, OX2 0JJ, United Kingdom.
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65
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Byars AW, Byars KC, Johnson CS, deGrauw TJ, Fastenau PS, Perkins S, Austin JK, Dunn DW. The relationship between sleep problems and neuropsychological functioning in children with first recognized seizures. Epilepsy Behav 2008; 13:607-13. [PMID: 18687412 PMCID: PMC2647721 DOI: 10.1016/j.yebeh.2008.07.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 07/02/2008] [Accepted: 07/23/2008] [Indexed: 01/26/2023]
Abstract
Epilepsy is associated with sleep disturbance, but little is known about how early this relationship develops and how it affects neuropsychological functioning. This study documented the frequency and types of sleep problems and examined how sleep problems are associated with seizures and neuropsychological functioning in 332 children following their first recognized seizure (ages 6-14) and in 225 sibling controls. Formal neuropsychological batteries were administered to all subjects. Sleep was measured using the Sleep Behavior Questionnaire and the Child Behavior Checklist. Sleep problems were more frequent in the seizure sample relative to siblings and previously published norms; bedtime difficulties, daytime somnolence, and parasomnias were the most frequently occurring sleep problems. In the seizure group, sleep problems were related to seizure parameters and to neuropsychological functioning. Seizure patients with significant sleep problems had worse neuropsychological functioning on all measures. Findings demonstrate the significant impact of sleep disturbance on children with newly recognized seizures.
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Affiliation(s)
- Anna W. Byars
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
| | - Kelly C. Byars
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
| | | | - Ton J. deGrauw
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center & University of Cincinnati College of Medicine
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66
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Dorris L, Scott N, Zuberi S, Gibson N, Espie C. Sleep problems in children with neurological disorders. Dev Neurorehabil 2008; 11:95-114. [PMID: 18415818 DOI: 10.1080/17518420701860149] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This review describes the complex and often reciprocal relationship between sleep problems, neurological disorders and/or intellectual disability in children. The causes of Intellectual disability (ID) discussed in this review include those conditions present from or around the time of birth, although it also considers traumatic brain injuries occurring later in development. This review discusses the patterns of sleep difficulty associated with specific disorders and summarizes the assessment and interventions, both behavioural and pharmacological, applicable to children. Many neurological disorders such as epilepsy, narcolepsy and neurorespiratory disorders vary considerably in terms of the degree of co-morbid problems and can present with a spectrum of effects on underlying cognitive or behavioural substrates including sleep function. These conditions are discussed as they provide useful insights into how disordered sleep can impact on cognitive development and behaviour. The review draws both on the literature in these areas and the extensive clinical experience of the authors.
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Affiliation(s)
- Liam Dorris
- Fraser of Allander Neurosciences Unit, Royal Hospital for Sick Children, Glasgow, UK.
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