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Sleep‐related hypermotor epilepsy: A prediction cohort study on sleep/awake patterns of seizures.

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Title: Sleep‐related hypermotor epilepsy: A prediction cohort study on sleep/awake patterns of seizures.
Authors: Licchetta, Laura (AUTHOR), Vignatelli, Luca (AUTHOR), Zenesini, Corrado (AUTHOR), Mostacci, Barbara (AUTHOR), Ferri, Lorenzo (AUTHOR), Provini, Federica (AUTHOR), Tinuper, Paolo (AUTHOR), Bisulli, Francesca (AUTHOR)
Source: Epilepsia (Series 4). Nov2019, Vol. 60 Issue 11, pe115-e120. 6p.
Subjects: Seizures (Medicine), Epilepsy, Cohort analysis, Sleep, Chi-squared test, Bruxism
Abstract: Sleep‐related hypermotor epilepsy (SHE) is characterized by hyperkinetic seizures arising from sleep. Awake seizures occasionally occur and are associated with a worse prognosis, with important implications for driving and quality of life. We evaluated the clinical features and sleep/wakefulness distribution of seizures at onset and lifelong in a large cohort of clinical/confirmed SHE. Chi‐square test and a multivariate logistic regression model were used to identify predictors of awake seizures lifelong (primary endpoint). Positive and negative likelihood ratio (LR+, LR‐) were calculated. We included 165 patients (male/female: 105/60) with a 27.6‐year median follow‐up. Most (67.9%) presented with seizures exclusively from sleep; 32.1% presented with seizures both while asleep and while awake, or exclusively during wakefulness. Presentation with seizures in wakefulness shows a sensitivity of 62.5% and a specificity of 96.5% to predict the occurrence of awake seizures lifelong, with an LR + of 18 (95% confidence interval [CI] = 5.75‐55) and LR‐ of 0.39 (95% CI = 0.29‐0.52). On multivariate analysis, distribution of sleep/awake seizures at onset was confirmed as an independent risk factor of awake seizures lifelong (odds ratio = 56.7). Patients presenting with awake seizures have a 94% probability of awake seizures lifelong, whereas in those presenting with asleep seizures only, the percentage lowers to 27%. This aspect should be mentioned during physician‐to‐patient communication about prognosis. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Sleep‐related hypermotor epilepsy: A prediction cohort study on sleep/awake patterns of seizures.
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Nov2019, Vol. 60 Issue 11, pe115-e120. 6p.
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  Data: Sleep‐related hypermotor epilepsy (SHE) is characterized by hyperkinetic seizures arising from sleep. Awake seizures occasionally occur and are associated with a worse prognosis, with important implications for driving and quality of life. We evaluated the clinical features and sleep/wakefulness distribution of seizures at onset and lifelong in a large cohort of clinical/confirmed SHE. Chi‐square test and a multivariate logistic regression model were used to identify predictors of awake seizures lifelong (primary endpoint). Positive and negative likelihood ratio (LR+, LR‐) were calculated. We included 165 patients (male/female: 105/60) with a 27.6‐year median follow‐up. Most (67.9%) presented with seizures exclusively from sleep; 32.1% presented with seizures both while asleep and while awake, or exclusively during wakefulness. Presentation with seizures in wakefulness shows a sensitivity of 62.5% and a specificity of 96.5% to predict the occurrence of awake seizures lifelong, with an LR + of 18 (95% confidence interval [CI] = 5.75‐55) and LR‐ of 0.39 (95% CI = 0.29‐0.52). On multivariate analysis, distribution of sleep/awake seizures at onset was confirmed as an independent risk factor of awake seizures lifelong (odds ratio = 56.7). Patients presenting with awake seizures have a 94% probability of awake seizures lifelong, whereas in those presenting with asleep seizures only, the percentage lowers to 27%. This aspect should be mentioned during physician‐to‐patient communication about prognosis. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/epi.16369
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        Text: English
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      – SubjectFull: Cohort analysis
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      – SubjectFull: Bruxism
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      – TitleFull: Sleep‐related hypermotor epilepsy: A prediction cohort study on sleep/awake patterns of seizures.
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              M: 11
              Text: Nov2019
              Type: published
              Y: 2019
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