![]() Correlations between night sleep duration and seizure frequency in temporal lobe epilepsy. Seizure precipitants (triggering factors) in patients with epilepsy. Sleep deprivation increases cortical excitability in epilepsy: syndrome-specific effects. ![]() This article highlights the importance of sleep recording to lateralize the irritative zone in patients with generalized discharges, who can then become surgical candidates.īadawy RA, Curatolo JM, Newton M, Berkovic SF, Macdonell RA. Rapid eye movement sleep reveals epileptogenic spikes for resective surgery in children with generalized interictal discharges. Predictors of sleepiness in epilepsy patients. Interictal spiking increases with sleep depth in temporal lobe epilepsy. Interictal spiking during wakefulness and sleep and the localization of foci in temporal lobe epilepsy. Distribution of partial seizures during the sleep–wake cycle: differences by seizure onset site. Relationship of epileptic seizures to sleep stage and sleep depth. Minecan D, Natarajan A, Marzec M, Malow B. Epilepsy and other chronic convulsive disorders. Papers of particular interest, published recently, have been highlighted as: Adequate control of seizures during sleep (especially generalized tonic-clonic seizures) decreases risk of sudden unexpected death in epilepsy (SUDEP). Sleep disorders that may worsen epilepsy such as obstructive sleep apnea or insomnia should be adequately treated to improve seizure frequency. Specific syndromes such as ESES require specific treatment such as a combination of high dose steroids, benzodiazepines, levetiracetam, and even surgery when an epileptogenic lesion is present. Risks of valproate should be considered before prescribing it to women of childbearing age. Valproate, lamotrigine, topiramate, levetiracetam, and perampanel are effective against generalized tonic-clonic seizures in genetic generalized epilepsies, which frequently happen on awakening. Drug-resistant cases should be evaluated for epilepsy surgery, which may be efficacious in this setting. These include both classical (such as carbamazepine) and new (such as levetiracetam and lacosamide) antiepileptic drugs. Drugs effective in focal epilepsy may be used to treat benign genetic focal epilepsies such as rolandic epilepsy and other focal (frontal or not) sleep epilepsies. Proper characterization of the epilepsy is essential to choose appropriate antiepileptic drugs. Treatment of sleep-related epilepsy should take in account the type of epileptic syndrome, the type of seizures, the patient characteristics, and also the pharmacokinetics of the drug. Interictal epileptiform discharges are activated by sleep deprivation and sleep, and some epilepsies occur almost exclusively during sleep. Sleep has a strong influence on interictal epileptiform discharges and on epileptic seizures.
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