This study evaluated the sleep–wake pattern, plasma melatonin levels and the urinary excretion of its metabolite, 6-sulphatoxy-melatonin among children with severe epileptic disorders, before and after a therapeutic trial with melatonin. Ten paediatric patients, suffering from severe epileptic disorders, were selected and given a nightly dose of 3 mg of a placebo, for 1 wk; for the next 3 months, the placebo was replaced with a nightly dose of 3 mg of melatonin. At the end of each treatment period, the urinary excretion of 6-sulphatoxy-melatonin (for the intervals 09.00 – 21:00 hr or 21:00–09:00 hr) and plasma levels of melatonin (recorded at 01:00, 05:00, 09:00, 13:00, 17:00 and 21:00 hr) were recorded, over a period of 24 hr; an actigraph record was also kept. Sleep efficiency among patients who received melatonin was significantly higher than among those given the placebo, with fewer night-time awakenings. Periodic plasma melatonin levels were regained and a better control gained of convulsive episodes, in that the number of seizures decreased. We conclude that melatonin is a good regulator of the sleep–wake cycle for paediatric patients suffering from severe epilepsy, moreover, it to a better control of convulsive episodes.

Normalization of the sleep-wake pattern and melatonin and 6-sulphatoxy-melatonin levels after a therapeutic trial with melatonin in children with severe epilepsy.

Apport de l’enregistrement d’une courte sieste après privation partielle de sommeil la veille en épileptologie pédiatrique

The role of sleep and sleep deprivation as inducer of paroxysmal abnormalities in EEG was studies in 104 infants and children under 14 years of age. These children suffered from various types of seizures and of normal standard EEG. These children who suffered from seizures of epileptic origin, after sleep deprivation had an EEG that showed a paroxysmal activity of 70.91% of the cases (p less than 0.001). The forced lack of sleep and the sleep that follows were found to be equally important as activators of paroxysmal abnormalities. The method of activation was found to be efficient in both partial an generalized seizures. The paroxysmal abnormalities were noted as being greater in phase II sleep. The EEG in sleep deprivation can show paroxysmal abnormalities, in children with epileptic seizures, that were hidden from standard EEG.

Martiń de Agar y Valverde Mc

Papers

EEG with sleep deprivation in epileptic children