Sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video‐EEG monitoring
Abstract This study evaluated sleep and respiratory abnormalities, and their relationship with seizures, in adults with developmental and epileptic encephalopathies (DEEs). We studied consecutive adults with DEEs undergoing inpatient video‐EEG monitoring and concurrent polysomnography between Decemb...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Epilepsia Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/epi4.12772 |
| _version_ | 1797729197632782336 |
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| author | Shobi Sivathamboo Kenneth A. Myers Andreas Pattichis Elise J. White Ka Nyuk Ku Terence J. O'Brien Piero Perucca Patrick Kwan |
| author_facet | Shobi Sivathamboo Kenneth A. Myers Andreas Pattichis Elise J. White Ka Nyuk Ku Terence J. O'Brien Piero Perucca Patrick Kwan |
| author_sort | Shobi Sivathamboo |
| collection | DOAJ |
| description | Abstract This study evaluated sleep and respiratory abnormalities, and their relationship with seizures, in adults with developmental and epileptic encephalopathies (DEEs). We studied consecutive adults with DEEs undergoing inpatient video‐EEG monitoring and concurrent polysomnography between December 2011 and July 2022. Thirteen patients with DEEs were included (median age: 31 years, range: 20–50; 69.2% female): Lennox–Gastaut syndrome (n = 6), Lennox–Gastaut syndrome‐like phenotype (n = 2), Landau–Kleffner syndrome (n = 1), epilepsy with myoclonic‐atonic seizures (n = 1), and unclassified DEEs (n = 3). Sleep architecture was often fragmented by epileptiform discharges and seizures resulting in arousals (median arousal index: 29.0 per h, range: 5.1–65.3). Moderate‐to‐severe obstructive sleep apnea (OSA) was observed in seven patients (53.8%). Three patients (23.1%) had tonic seizures that frequently occurred with central apnea; one met criteria for mild central sleep apnea. Of the patients with tonic seizures, two had other identifiable seizure manifestations, but in one patient, central apnea was commonly the only discernable seizure manifestation. Polysomnography during video‐EEG is an effective diagnostic tool in detecting sleep and seizure‐related respiratory abnormalities. Clinically significant OSA may increase the risk of comorbid cardiovascular disease and premature mortality. Treatment of epilepsy may improve sleep quality, and conversely, improved sleep, may decrease seizure burden. |
| first_indexed | 2024-03-12T11:25:36Z |
| format | Article |
| id | doaj.art-d97d0b7695fe4f0cb176a0c221456f46 |
| institution | Directory Open Access Journal |
| issn | 2470-9239 |
| language | English |
| last_indexed | 2024-03-12T11:25:36Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Epilepsia Open |
| spelling | doaj.art-d97d0b7695fe4f0cb176a0c221456f462023-09-01T09:39:51ZengWileyEpilepsia Open2470-92392023-09-01831157116810.1002/epi4.12772Sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video‐EEG monitoringShobi Sivathamboo0Kenneth A. Myers1Andreas Pattichis2Elise J. White3Ka Nyuk Ku4Terence J. O'Brien5Piero Perucca6Patrick Kwan7Department of Neuroscience, Central Clinical School Monash University Melbourne Victoria AustraliaResearch Institute of the McGill University Health Centre Montreal Quebec CanadaDepartment of Neuroscience, Central Clinical School Monash University Melbourne Victoria AustraliaDepartment of Neurology The Royal Melbourne Hospital Parkville Victoria AustraliaDepartment of Neurology Alfred Health Melbourne Victoria AustraliaDepartment of Neuroscience, Central Clinical School Monash University Melbourne Victoria AustraliaDepartment of Neuroscience, Central Clinical School Monash University Melbourne Victoria AustraliaDepartment of Neuroscience, Central Clinical School Monash University Melbourne Victoria AustraliaAbstract This study evaluated sleep and respiratory abnormalities, and their relationship with seizures, in adults with developmental and epileptic encephalopathies (DEEs). We studied consecutive adults with DEEs undergoing inpatient video‐EEG monitoring and concurrent polysomnography between December 2011 and July 2022. Thirteen patients with DEEs were included (median age: 31 years, range: 20–50; 69.2% female): Lennox–Gastaut syndrome (n = 6), Lennox–Gastaut syndrome‐like phenotype (n = 2), Landau–Kleffner syndrome (n = 1), epilepsy with myoclonic‐atonic seizures (n = 1), and unclassified DEEs (n = 3). Sleep architecture was often fragmented by epileptiform discharges and seizures resulting in arousals (median arousal index: 29.0 per h, range: 5.1–65.3). Moderate‐to‐severe obstructive sleep apnea (OSA) was observed in seven patients (53.8%). Three patients (23.1%) had tonic seizures that frequently occurred with central apnea; one met criteria for mild central sleep apnea. Of the patients with tonic seizures, two had other identifiable seizure manifestations, but in one patient, central apnea was commonly the only discernable seizure manifestation. Polysomnography during video‐EEG is an effective diagnostic tool in detecting sleep and seizure‐related respiratory abnormalities. Clinically significant OSA may increase the risk of comorbid cardiovascular disease and premature mortality. Treatment of epilepsy may improve sleep quality, and conversely, improved sleep, may decrease seizure burden.https://doi.org/10.1002/epi4.12772DEEepilepsysleep‐disordered breathing |
| spellingShingle | Shobi Sivathamboo Kenneth A. Myers Andreas Pattichis Elise J. White Ka Nyuk Ku Terence J. O'Brien Piero Perucca Patrick Kwan Sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video‐EEG monitoring Epilepsia Open DEE epilepsy sleep‐disordered breathing |
| title | Sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video‐EEG monitoring |
| title_full | Sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video‐EEG monitoring |
| title_fullStr | Sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video‐EEG monitoring |
| title_full_unstemmed | Sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video‐EEG monitoring |
| title_short | Sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video‐EEG monitoring |
| title_sort | sleep and respiratory abnormalities in adults with developmental and epileptic encephalopathies using polysomnography and video eeg monitoring |
| topic | DEE epilepsy sleep‐disordered breathing |
| url | https://doi.org/10.1002/epi4.12772 |
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