scholarly journals Lateralized interictal epileptiform discharges during rapid eye movement sleep correlate with epileptogenic hemisphere in children with intractable epilepsy secondary to tuberous sclerosis complex

Epilepsia ◽  
2011 ◽  
Vol 52 (11) ◽  
pp. 1986-1994 ◽  
Author(s):  
Ayako Ochi ◽  
Ryan Hung ◽  
Shelly Weiss ◽  
Elysa Widjaja ◽  
Tonia To ◽  
...  
SLEEP ◽  
2019 ◽  
Vol 43 (5) ◽  
Author(s):  
Marna B McKenzie ◽  
Michelle-Lee Jones ◽  
Aoife O’Carroll ◽  
Demitre Serletis ◽  
Leigh Anne Shafer ◽  
...  

Abstract Study Objectives Rapid eye movement sleep (REM) usually suppresses interictal epileptiform discharges (IED) and seizures. However, breakthrough IEDs in REM sometimes continue. We aimed to determine if the amount of IED and seizures in REM, or REM duration, is associated with clinical trajectories. Methods Continuous electroencephalogram (EEG) recordings from the epilepsy monitoring unit (EMU) were clipped to at least 3 h of concatenated salient findings per day including all identified REM. Concatenated EEG files were analyzed for nightly REM duration and the “REM spike burden” (RSB), defined as the proportion of REM occupied by IED or seizures. Patient charts were reviewed for clinical data, including patient-reported peak seizure frequency. Logistic and linear regressions were performed, as appropriate, to explore associations between two explanatory measures (duration of REM and RSB) and six indicators of seizure activity (clinical trajectory outcomes). Results The median duration of REM sleep was 43.3 (IQR 20.9–73.2) min per patient per night. 59/63 (93.7%) patients achieved REM during EMU admission. 39/59 (66.1%) patients had breakthrough IEDs or seizures in REM with the median RSB at 0.7% (IQR 0%–8.4%). Every 1% increase in RSB was associated with 1.69 (95% CI = 0.47–2.92) more seizures per month during the peak seizure period of one’s epilepsy (p = 0.007). Conclusions Increased epileptiform activity during REM is associated with increased peak seizure frequency, suggesting an overall poorer epilepsy trajectory. Our findings suggest that RSB in the EMU is a useful biomarker to help guide about what to expect over the course of one’s epilepsy.


2021 ◽  
Vol 11 (1) ◽  
pp. 1-5
Author(s):  
Harinder Jaseja

Epilepsy is one of the commonest and oldest neurological diseases in the history of mankind, the exact pathophysiology of the evolution of which still remains elusive. The intimate and intriguing relation between epilepsy and sleep has been known for a long time. Rapid eye movement sleep (REMS) is well documented to exert potent antiepileptic action in human epilepsies and the underlying mechanism of which is largely based on its property to induce widespread electroencephalogram (EEG)-desynchronization. The pedunculopontine nucleus (PPN) owing to its property to enhance REMS has recently been under study for its potential role in intractable epilepsy (IE) and has been proposed as a novel deep brain stimulation target in IE. This brief paper unfolds the existing role of PPN, REMS, and EEG-desynchronization (PRED) in the evolution of epilepsy in an axial manner, the realization and comprehension of which is likely to open new avenues for further understanding of epileptogenesis, improved treatment of epilepsy and reducing the risk of IE.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Minji Lee ◽  
Benjamin Baird ◽  
Olivia Gosseries ◽  
Jaakko O. Nieminen ◽  
Melanie Boly ◽  
...  

2010 ◽  
Vol 110 (5) ◽  
pp. 1283-1289 ◽  
Author(s):  
George A. Mashour ◽  
William J. Lipinski ◽  
Lisa B. Matlen ◽  
Amanda J. Walker ◽  
Ashley M. Turner ◽  
...  

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