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Epileptic discharges and phasic sleep phenomena in patients with juvenile myoclonic epilepsy.

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Title: Epileptic discharges and phasic sleep phenomena in patients with juvenile myoclonic epilepsy.
Authors: Bonakis, Anastasios, Koutroumanidis, Michalis
Source: Epilepsia (Series 4). Nov2009, Vol. 50 Issue 11, p2434-2445. 12p. 4 Charts.
Subjects: Epilepsy, Infantile spasms, Rapid eye movement sleep, Electroencephalography, Sleep stages
Abstract: Epileptiform discharges (EDs) may be part of the internal arousing stimuli that affect the quality of sleep in patients with epilepsies. We studied the association between EDs and sleep phasic phenomena, and its relevance to seizure control in 19 patients with juvenile myoclonic epilepsy (JME). We analyzed the first cycle of non-REM (rapid eye movement) sleep in 22 sleep-deprived electroencephalography (EEG) studies and classified EDs within the cyclical alternating pattern (CAP) frame, grouping separately the EDs that occurred at the transition between phases (B to A and A to B). Within CAP periods, 36.7% of EDs occurred in A phase, 26.7% in B phase, 31.5% at “B to A” transition, and 3% at “A to B” transition. Poor seizure control was strongly associated with increased EDs in phase B (p = 0.0016) and at the “B to A” transition (p = 0.002), but marginally with increased EDs in phase A (p = 0.03). Focal spikes were increased in phase B. EDs are facilitated by increased vigilance (A phase), but they may also enhance CAP cycling by generating A phases when those that occur at the “B to A” transition are interpreted as successfully breaking through the state of reduced arousal (phase B) because of increased epileptic pressure. This promotes sleep instability and further fosters epileptic activity, and conceivably seizures. This hypothesis is also supported by the strong correlation between EDs during phase B (including “B” and “B to A”) and poor seizure control. The enhanced nonlocalizing focal spikes in phase B may reflect successful inhibition of generalized EDs. [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: Epileptic discharges and phasic sleep phenomena in patients with juvenile myoclonic epilepsy.
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Nov2009, Vol. 50 Issue 11, p2434-2445. 12p. 4 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Infantile+spasms%22">Infantile spasms</searchLink><br /><searchLink fieldCode="DE" term="%22Rapid+eye+movement+sleep%22">Rapid eye movement sleep</searchLink><br /><searchLink fieldCode="DE" term="%22Electroencephalography%22">Electroencephalography</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep+stages%22">Sleep stages</searchLink>
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  Data: Epileptiform discharges (EDs) may be part of the internal arousing stimuli that affect the quality of sleep in patients with epilepsies. We studied the association between EDs and sleep phasic phenomena, and its relevance to seizure control in 19 patients with juvenile myoclonic epilepsy (JME). We analyzed the first cycle of non-REM (rapid eye movement) sleep in 22 sleep-deprived electroencephalography (EEG) studies and classified EDs within the cyclical alternating pattern (CAP) frame, grouping separately the EDs that occurred at the transition between phases (B to A and A to B). Within CAP periods, 36.7% of EDs occurred in A phase, 26.7% in B phase, 31.5% at “B to A” transition, and 3% at “A to B” transition. Poor seizure control was strongly associated with increased EDs in phase B (p = 0.0016) and at the “B to A” transition (p = 0.002), but marginally with increased EDs in phase A (p = 0.03). Focal spikes were increased in phase B. EDs are facilitated by increased vigilance (A phase), but they may also enhance CAP cycling by generating A phases when those that occur at the “B to A” transition are interpreted as successfully breaking through the state of reduced arousal (phase B) because of increased epileptic pressure. This promotes sleep instability and further fosters epileptic activity, and conceivably seizures. This hypothesis is also supported by the strong correlation between EDs during phase B (including “B” and “B to A”) and poor seizure control. The enhanced nonlocalizing focal spikes in phase B may reflect successful inhibition of generalized EDs. [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.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=44788939
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        Value: 10.1111/j.1528-1167.2009.02110.x
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        Text: English
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      – SubjectFull: Rapid eye movement sleep
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      – SubjectFull: Electroencephalography
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      – SubjectFull: Sleep stages
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              Text: Nov2009
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