Sleep and Epilepsy: Strange Bedfellows No More

摘要: Ancient philosophers and theologians believed that altered consciousness freed the mind to prophesy future, equating sleep with seizures. Only recently has bidirectional influences of epilepsy upon one another received more substantive analysis. This article reviews complex increasingly recognized interrelationships between epilepsy. NREM differentially activates interictal epileptiform discharges during slow wave (N3) sleep, while ictal seizure events occur frequently light stages N1 N2. The most commonly encountered types sleep-related epilepsies (those preferential occurrence or following arousal) include frontal temporal lobe partial in adults, benign childhood centrotemporal spikes (benign rolandic epilepsy) juvenile myoclonic children adolescents. Comorbid disorders are frequent patients epilepsy, particularly obstructive apnea refractory which may aggravate burden, treatment nasal continuous positive airway pressure often improves frequency. Distinguishing nocturnal such as parasomnias (confusional arousals, walking, night terrors), REM including behavior disorder, seizures if difficult benefits from careful history taking video-EEG-polysomnography selected cases. Differentiating primary is essential for determining appropriate therapy, recognizing co-existent improve their burden quality life.