Electrographic status epilepticus during non-REM sleep: A report of three cases

1997 ◽  
Vol 103 (1) ◽  
pp. 216
Author(s):  
S Hajnsek
Keyword(s):  
SLEEP ◽  
2020 ◽  
Vol 43 (11) ◽  
Author(s):  
Bart van den Munckhof ◽  
Silvano R Gefferie ◽  
Suus A M van Noort ◽  
Heleen C van Teeseling ◽  
Mischa P Schijvens ◽  
...  

Abstract Study Objectives Encephalopathy with electrical status epilepticus in sleep (ESES) is characterized by non-rapid eye movement (non-REM)-sleep-induced epileptiform activity and acquired cognitive deficits. The synaptic homeostasis hypothesis describes the process of daytime synaptic potentiation balanced by synaptic downscaling in non-REM-sleep and is considered crucial to retain an efficient cortical network. We aimed to study the overnight decline of slow waves, an indirect marker of synaptic downscaling, in patients with ESES and explore whether altered downscaling relates to neurodevelopmental and behavioral problems. Methods Retrospective study of patients with ESES with at least one whole-night electroencephalogram (EEG) and neuropsychological assessment (NPA) within 4 months. Slow waves in the first and last hour of non-REM-sleep were analyzed. Differences in slow-wave slope (SWS) and overnight slope course between the epileptic focus and non-focus electrodes and relations to neurodevelopment and behavior were analyzed. Results A total of 29 patients with 44 EEG ~ NPA combinations were included. Mean SWS decreased from 357 to 327 µV/s (−8%, p < 0.001) across the night and the overnight decrease was less pronounced in epileptic focus than in non-focus electrodes (−5.6% vs. −8.7%, p = 0.003). We found no relation between SWS and neurodevelopmental test results in cross-sectional and longitudinal analyses. Patients with behavioral problems showed less SWS decline than patients without and the difference was most striking in the epileptic focus (−0.9% vs. −8.8%, p = 0.006). Conclusions Slow-wave homeostasis—a marker of synaptic homeostasis—is disturbed by epileptiform activity in ESES. Behavioral problems, but not neurodevelopmental test results, were related to severity of this disturbance.


2000 ◽  
Vol 42 (6) ◽  
pp. 428-428 ◽  
Author(s):  
P Grattan-Smith ◽  
I Hopkins ◽  
L Shield ◽  
D Boldt

2000 ◽  
Vol 14 (3) ◽  
pp. 151-158 ◽  
Author(s):  
José Luis Cantero ◽  
Mercedes Atienza

Abstract High-resolution frequency methods were used to describe the spectral and topographic microstructure of human spontaneous alpha activity in the drowsiness (DR) period at sleep onset and during REM sleep. Electroencephalographic (EEG), electrooculographic (EOG), and electromyographic (EMG) measurements were obtained during sleep in 10 healthy volunteer subjects. Spectral microstructure of alpha activity during DR showed a significant maximum power with respect to REM-alpha bursts for the components in the 9.7-10.9 Hz range, whereas REM-alpha bursts reached their maximum statistical differentiation from the sleep onset alpha activity at the components between 7.8 and 8.6 Hz. Furthermore, the maximum energy over occipital regions appeared in a different spectral component in each brain activation state, namely, 10.1 Hz in drowsiness and 8.6 Hz in REM sleep. These results provide quantitative information for differentiating the drowsiness alpha activity and REM-alpha by studying their microstructural properties. On the other hand, these data suggest that the spectral microstructure of alpha activity during sleep onset and REM sleep could be a useful index to implement in automatic classification algorithms in order to improve the differentiation between the two brain states.


2019 ◽  
Vol 19 (03) ◽  
pp. 186-193
Author(s):  
Bernhard Schmitt

ZusammenfassungSchlaf und Epilepsie stehen in enger Beziehung zueinander. 20 % der Epilepsiepatienten erleiden Anfälle nur in der Nacht, 40 % nur am Tag und 35 % bei Tag und Nacht. Kinder mit Panayiotopoulos-Syndrom oder Rolando-Epilepsie erleiden ihre Anfälle vorwiegend im Schlaf und zeigen im NREM-Schlaf eine Zunahme der Spike-waves. ESES (elektrischer Status epilepticus im Schlaf) und Landau-Kleffner-Syndrom sind epileptische Enzephalopathien mit ausgeprägten kognitiven Einbrüchen, Verhaltensauffälligkeiten und Anfällen. Kennzeichnend ist eine kontinuierliche Spike-wave-Aktivität im NREM-Schlaf. Patienten mit juveniler Myoklonusepilepsie oder Aufwach-Grand-Mal-Epilepsie haben ihre Anfälle nach dem Aufwachen, nicht selten nach vorausgehendem Schlafentzug. Nächtliche Frontallappen-Anfälle werden oft mit Parasomnien verwechselt. Für eine korrekte Zuordnung ist es hilfreich, die klinische Symptomatik und die Häufigkeit pro Nacht und Monat in die Beurteilung mit einzubeziehen. Nächtliche Anfälle und Antikonvulsiva wirken sich auf den Schlaf aus. Schlafstörungen sollten erkannt und behandelt werden, da dies die Anfallskontrolle und Lebensqualität verbessern kann. Bei Verdacht auf Epilepsie und nicht schlüssigem Wach-EEG können Schlaf-EEGs hilfreich sein. Abhängig von der Fragestellung kann das EEG im Mittagsschlaf (natürlicher Schlaf oder medikamentös induziert), während der Nacht oder nach vorausgehendem Schlafentzug stattfinden.


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