scholarly journals Mr. Potato Head

2019 ◽  
pp. 468-487
Author(s):  
Nancy Foldvary-Schaefer ◽  
Thapanee Somboon ◽  
Zahreddin Alsheikhtaha
Keyword(s):  
Sleep Apnea ◽  
Sleep Disorders ◽  
Developmental Delay ◽  
Epileptic Encephalopathy ◽  
Electrode Placement ◽  
Age Related ◽  
Generalized Epilepsy ◽  
Patients With Epilepsy ◽  
Spike Wave

This case illustrates diagnostic challenges in patients with epilepsy and suspected sleep disorders. Specifically, the symptomatic generalized epilepsy Lennox-Gastaut syndrome is an age-related epileptic encephalopathy characterized by developmental delay; multiple seizure types, including tonic seizures in drowsiness and sleep; and generalized slow spike-wave complexes on electroencephalography (EEG). Tonic seizures in sleep can be unrecognized or can be confused with sleep disorders such as sleep apnea. The case demonstrates how to identify generalized epileptic abnormalities and seizures on the limited EEG montage used in routine polysomnography and expanded EEG using the 10-20 system of electrode placement.

scholarly journals Continuous Spike-Wave during Slow Wave Sleep and Related Conditions

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Nilika Shah Singhal ◽  
Joseph E. Sullivan
Keyword(s):  
Slow Wave ◽  
Slow Wave Sleep ◽  
Treatment Strategies ◽  
Epileptic Encephalopathy ◽  
Related Condition ◽  
Age Related ◽  
Hormonal Therapies ◽  
Electroencephalogram Eeg ◽  
International League ◽  
Spike Wave

Continuous spike and wave during slow wave sleep (CSWS) is an epileptic encephalopathy that presents with neurocognitive regression and clinical seizures, and that demonstrates an electroencephalogram (EEG) pattern of electrical status epilepticus during sleep, as defined by the Commission on Classification and Terminology of the International League Against Epilepsy 1989. CSWS is an age-related condition, typically presenting in children around 5 years of age, with clinical seizures which progress within 2 years to a severe epileptic encephalopathy. The pathophysiology of CSWS is not completely understood, but the corticothalamic neuronal network involved in sleep patterns is thought to be involved. Genetic predisposition and injury in early development are thought to play etiological roles. Treatment strategies have involved traditional anticonvulsants, hormonal therapies, and other newer techniques. Outcomes are fair, and the thought is that earlier diagnosis and intervention preserve neurocognitive development, as in the case of other epileptic encephalopathies. Further understanding of the mechanisms of CSWS may lead to improved therapeutic options and thus outcomes of children with CSWS.

scholarly journals Chronotypes in Patients with Epilepsy: Does the Type of Epilepsy Make a Difference?

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Hallie Kendis ◽  
Kelly Baron ◽  
Stephan U. Schuele ◽  
Bhavita Patel ◽  
Hrayr Attarian
Keyword(s):  
Seizure Control ◽  
Focal Epilepsy ◽  
Healthy Controls ◽  
Circadian Misalignment ◽  
Age Related ◽  
Primary Generalized Epilepsy ◽  
Generalized Epilepsy ◽  
Patients With Epilepsy ◽  
The Impact ◽  
Related Increase

Circadian rhythms govern all biological functions. Circadian misalignment has a major impact on health. Late chronotype is a risk factor for circadian misalignment which in turn can affect the control of seizures in epilepsy patients. We compared a group of 87 confirmed epilepsy patients regardless of subtypes with age- and sex-matched healthy controls. We compared generalized epilepsy patients with localization related epilepsy patients and with healthy controls. We found that primary generalized epilepsy patients were 5 times more likely to have a late chronotype than healthy controls. We did not find any significant differences between localization related epilepsy patients and healthy controls or between the overall epilepsy cohort and healthy controls. Generalized epilepsy patients are more likely to be evening types as compared to those with focal epilepsy or subjects without epilepsy. Epilepsy patients do not experience the same age related increase in morningness as do age-matched healthy controls. This is important in regard to timing of AED, identifying and preventing sleep deprivation, and integrating chronotype evaluations and chronotherapy in comprehensive epilepsy care. Further studies, using objective phase markers or the impact of chronotherapy on seizure control, are necessary.

Sleep and epilepsy—chicken or egg?

2018 ◽  
Author(s):  
Dora A. Lozsadi
Keyword(s):  
Side Effects ◽  
Sleep Disorders ◽  
Learning Disability ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Seizure Control ◽  
Subjective Sleep ◽  
Neurological Conditions ◽  
The Uk ◽  
Patients With Epilepsy

Epilepsy is the commonest serious chronic neurological condition, affecting 0.5% of the population in the UK. Subjective sleep disturbance and excessive daytime sleepiness are reported to be 50% more frequent in those with epilepsy than in controls. Causes are multiple. Both poor seizure control and nocturnal attacks are known to contribute to such sleep disorders. Epilepsy also increases the risk of associated sleep disorders, and additional neurological conditions, such as dementia, learning disability, and depression. These all affect sleep hygiene. Prescribed anti-epileptic drugs will further aggravate the problem. Side-effects will include drowsiness. Sedating benzodiazepines and barbiturates are considered worst offenders. Others affect sleep architecture to varying degrees and/or cause insomnia. While hyper-somnolence in patients with epilepsy will raise the possibility of any of the above issues, sleep deprivation is one of the commonest seizure triggers. This chapter will shed more light on the intricate relationship between sleep and epilepsy.

scholarly journals Mutations in the Na+/Citrate Cotransporter NaCT (SLC13A5) in Pediatric Patients with Epilepsy and Developmental Delay

2016 ◽  
Vol 22 (1) ◽  
pp. 310-321 ◽  
Author(s):  
Jenna Klotz ◽  
Brenda E Porter ◽  
Claire Colas ◽  
Avner Schlessinger ◽  
Ana M Pajor
Keyword(s):  
Developmental Delay ◽  
Pediatric Patients ◽  
Patients With Epilepsy

Geriatric Otolaryngology

2021 ◽  
Author(s):  
Christian Caceres ◽  
Kourosh Parham
Keyword(s):  
Obstructive Sleep Apnea ◽  
Hearing Loss ◽  
Sleep Apnea ◽  
Head And Neck ◽  
Malignant Neoplasms ◽  
Geriatric Syndromes ◽  
Healthcare Needs ◽  
Age Related ◽  
Obstructive Sleep ◽  
Age Related Hearing Loss

With increasing life expectancy, the unique healthcare needs of the older patient are being better appreciated. To address these growing needs, which differ from those of the average adult patient, otolaryngologists must acquire new knowledge and competencies. This chapter provides a broad overview of geriatric otolaryngology and highlights subspecialty topics where otolaryngologists are called upon to administer care. These include age-related hearing loss, balance disorders, sinonasal disease, voice and swallowing disorders, obstructive sleep apnea and head and neck cancer. Geriatric concerns in each of these specific areas have to be addressed in the broader context of geriatric syndromes in coordination with geriatricians or other geriatric-trained providers to advance an integrated, team-based approach to maintaining or restoring the older patients’ well-being. This review contains 3 figures, 2 tables and 161 references Keywords: Cognitive decline, delirium, frailty, age-related hearing loss, presbystasis, presbylarynx, immunosenecense, presbynasalis, vasomotor rhinitis, chronic sinusitis, age-related oflactory decline, dysphagia, head and neck malignant neoplasms, obstructive sleep apnea, geriatric syndromes and perioperative optimization.

Sleep Disorders

2015 ◽  
Author(s):  
Sudhansu Chokroverty
Keyword(s):  
Sleep Apnea ◽  
Sleep Disorders ◽  
Eye Movement ◽  
Rem Sleep ◽  
Sleep Apnea Syndrome ◽  
Nrem Sleep ◽  
Rapid Eye Movement ◽  
Circadian Rhythm Sleep Disorders ◽  
Apnea Syndrome ◽  
Sleep Mechanism

Recent research has generated an enormous fund of knowledge about the neurobiology of sleep and wakefulness. Sleeping and waking brain circuits can now be studied by sophisticated neuroimaging techniques that map different areas of the brain during different sleep states and stages. Although the exact biologic functions of sleep are not known, sleep is essential, and sleep deprivation leads to impaired attention and decreased performance. Sleep is also believed to have restorative, conservative, adaptive, thermoregulatory, and consolidative functions. This review discusses the physiology of sleep, including its two independent states, rapid eye movement (REM) and non–rapid eye movement (NREM) sleep, as well as functional neuroanatomy, physiologic changes during sleep, and circadian rhythms. The classification and diagnosis of sleep disorders are discussed generally. The diagnosis and treatment of the following disorders are described: obstructive sleep apnea syndrome, narcolepsy-cataplexy sydrome, idiopathic hypersomnia, restless legs syndrome (RLS) and periodic limb movements in sleep, circadian rhythm sleep disorders, insomnias, nocturnal frontal lobe epilepsy, and parasomnias. Sleep-related movement disorders and the relationship between sleep and psychiatric disorders are also discussed. Tables describe behavioral and physiologic characteristics of states of awareness, the international classification of sleep disorders, common sleep complaints, comorbid insomnia disorders, causes of excessive daytime somnolence, laboratory tests to assess sleep disorders, essential diagnostic criteria for RLS and Willis-Ekbom disease, and drug therapy for insomnia. Figures include polysomnographic recording showing wakefulness in an adult; stage 1, 2, and 3 NREM sleep in an adult; REM sleep in an adult; a patient with sleep apnea syndrome; a patient with Cheyne-Stokes breathing; a patient with RLS; and a patient with dream-enacting behavior; schematic sagittal section of the brainstem of the cat; schematic diagram of the McCarley-Hobson model of REM sleep mechanism; the Lu-Saper “flip-flop” model; the Luppi model to explain REM sleep mechanism; and a wrist actigraph from a man with bipolar disorder. This review contains 14 highly rendered figures, 8 tables, 115 references, and 5 MCQs.

scholarly journals Sleep disorder: a possible cause of attention deficit in children and adolescents with Chiari malformation type II

2009 ◽  
Vol 67 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Paulo Sérgio Azeredo Henriques Filho ◽  
Riccardo Pratesi
Keyword(s):  
Sleep Apnea ◽  
Sleep Disorders ◽  
Attention Deficit ◽  
Chiari Malformation ◽  
Sleep Apnea Syndrome ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Type Ii ◽  
Sleep Behavior ◽  
Apnea Syndrome

BACKGROUND: Attention deficit may be related to sleep disorders in Chiari malformation type II (CMII). Our aim is identify sleep disorders and their specific contribution in attention deficit. METHOD: We selected 24 patients with CM II and 24 without CM II. DSM-IV criteria and a neuropsychological analysis were applied in all. All patients underwent full night polysomnography. RESULTS: 14 CM II patients presented sleep apnea syndrome, REM sleep behavior disorder and periodic limb movement in sleep; six patients without CM II presented sleep apnea syndrome. Among these patients, 12 (six with CM II and six without CM II) presented attention deficit related to the sleep disorders. CONCLUSION: Sleep disorders may impair cognitive functions, as attention, and contribute to poor quality of learning also in patients with CM II.

Obstructive Sleep Apnea Syndrome and Age-Related Hypogonadism

2018 ◽  
Vol 49 (1) ◽  
pp. 64-68
Author(s):  
I. M. Madaeva ◽  
O. N. Berdina ◽  
N. V. Semenova ◽  
V. V. Madaev ◽  
L. V. Rychkova ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Age Related ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Epileptic Encephalopathies: An Overview

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Sonia Khan ◽  
Raidah Al Baradie
Keyword(s):  
Slow Wave Sleep ◽  
Epileptic Encephalopathy ◽  
Dravet Syndrome ◽  
Management Options ◽  
Epileptic Encephalopathies ◽  
Age Related ◽  
Ohtahara Syndrome ◽  
Cerebral Dysfunction ◽  
Epileptic Syndromes

Epileptic encephalopathies are an epileptic condition characterized by epileptiform abnormalities associated with progressive cerebral dysfunction. In the classification of the International League Against Epilepsy eight age-related epileptic encephalopathy syndromes are recognized. These syndromes include early myoclonic encephalopathy and Ohtahara syndrome in the neonatal period, West syndrome and Dravet syndrome in infancy, myoclonic status in nonprogressive encephalopathies, and Lennox-Gastaut syndrome, Landau-Kleffner syndrome, and epilepsy with continuous spike waves during slow wave sleep in childhood and adolescences. Other epileptic syndromes such as migrating partial seizures in infancy and severe epilepsy with multiple independent spike foci may be reasonably added. In this paper, we provide an overview of epileptic encephalopathies including clinical neurophysiological features, cognitive deterioration, and management options especially that these conditions are generally refractory to standard antiepileptic drugs.

scholarly journals The Association of Unreported Sleep Disturbances and Systemic Inflammation: Findings from the 2005-2008 NHANES

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Jeff A. Dennis ◽  
Ahmad Alazzeh ◽  
Ann Marie Kumfer ◽  
Rebecca McDonald-Thomas ◽  
Alan N. Peiris
Keyword(s):  
Sleep Apnea ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Inflammatory Markers ◽  
Sleep Disturbances ◽  
Laboratory Data ◽  
Poor Sleep ◽  
Distribution Width ◽  
Inflammatory Status

Background/Objective. Sleep apnea is associated with elevated inflammatory markers. A subgroup of patients never report sleep disturbances to their physician. The inflammatory status of this subgroup is not known. The present study aims to evaluate two inflammatory markers, C-reactive protein (CRP) and red cell distribution width (RDW), in those with unreported sleep disturbances and compares these findings to those with and without reported sleep disorders. We also investigate the utility of RDW as an inflammatory marker in sleep disorders. Methods. Sample includes 9,901 noninstitutionalized, civilian, nonpregnant adults from the 2005-2008 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional U.S. study. Sleep questionnaire and laboratory data were used to compare inflammatory markers (CRP and RDW) in five subgroups of individuals: reporting physician-diagnosed sleep apnea, reporting another physician-diagnosed sleep disorder, reported sleep disturbance to physician with no resulting diagnosis, unreported sleep disturbance (poor sleep quality not reported to physician), and no diagnosed sleep disorder or sleep disturbance. Results. Individuals with unreported sleep disturbance had significantly higher odds of elevated RDW (>13.6%) when compared to those without a sleep disturbance in adjusted models (OR=1.33). Those with unreported sleep disturbance had significantly higher odds of elevated CRP levels (>1 mg/L) than those without sleep disturbances (OR 1.34), although the association was not significant when adjusted for obesity and other controls. Conclusion. Self-identified unreported sleep disturbances are associated with significantly higher odds of elevated RDW than those without sleep disturbances. RDW may serve as a valuable indicator in identifying individuals at higher risk for sleep apnea and other sleep disorders.

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