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Journal ArticleDOI

Effect of successful epilepsy surgery on subjective and objective sleep parameters – a prospective study

TL;DR: Epilepsy surgery improves subjective sleep parameters in patients with medically refractory epilepsy during the early post operative period and may improve objective (PSG documented) sleep quality, sleep architecture and obstructive sleep apnea with resultant reduction in excessive daytime sleepiness.
About: This article is published in Sleep Medicine.The article was published on 2013-04-01. It has received 39 citations till now. The article focuses on the topics: Polysomnography & Excessive daytime sleepiness.
Citations
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Journal ArticleDOI
TL;DR: Identifying and treating unrecognized sleep disorders and understanding the impact of circadian rhythms on epilepsy can improve quality of life and seizure control in AWE.
Abstract: Purpose of review To summarize recent studies on the complex relationships between sleep disorders, sleep, and epilepsy. Recent findings Insomnia in adults with epilepsy (AWE) warrants consideration of depression, anxiety, and suicidal ideation. Daytime sleepiness in AWE is more often due to undiagnosed sleep disorders. Sleep deprivation is an important provoker of seizures in juvenile myoclonic epilepsy. Abnormalities in frontal lobe executive function with difficulties making advantageous decisions may explain failure of juvenile myoclonic epilepsy patients to adhere to treatment recommendations and regulate their sleep habits. Sleep architecture in AWE is more likely to be abnormal if seizures are poorly controlled or occur during sleep. Obstructive sleep apnea is much more common in AWE who are man, older, heavier, or whose seizures are poorly controlled. Chronobiology and chronopharmacology of epilepsy is an emerging field worthy of future research and clinical applications. Summary Identifying and treating unrecognized sleep disorders and understanding the impact of circadian rhythms on epilepsy can improve quality of life and seizure control in AWE.

29 citations

Book ChapterDOI
01 Jan 2017
TL;DR: This chapter outlines an interaction between sleep and epilepsy including effect of sleep on epilepsy, epilepsy onSleep, and antiepileptic medication on sleep, preceded by a brief discussion about mechanism of epilepsy and sleep.
Abstract: This chapter outlines an interaction between sleep and epilepsy including effect of sleep on epilepsy, epilepsy on sleep, and antiepileptic medication on sleep, preceded by a brief discussion about mechanism of epilepsy and sleep. We also mention about the impact of autonomic nervous system and sleep apnea in epilepsy. Finally, we discuss about special seizure types occurring during night as well as diagnostic procedures and practical relevance to understanding the relationship between sleep and epilepsy.

28 citations

Journal ArticleDOI
TL;DR: It is advisable to include objective and subjective sleep parameters in the initial evaluation and follow-up of patients considered for invasive procedures for epilepsy control, especially with VNS due to the risk of sleep apnoea.
Abstract: Purpose Perform a systematic review of the literature on the effects of vagus nerve stimulation (VNS), deep brain stimulation (DBS) and epilepsy surgery in subjective and objective sleep parameters. Methods We performed a literature search in the main medical databases: Medline, Embase, Cochrane, DARE and LILACS, looking for studies that evaluated the effects of VNS, DBS or epilepsy surgery on sleep parameters. In all, 36 studies, coming from 11 countries, including reviews, cohort studies, case series and case reports were included. Results VNS induces sleep apnoea dependent of the stimulation variables. This condition can be reverted modifying these settings. Surgical procedures for epilepsy cause an improvement in objective and subjective sleep parameters that depend on the success of the procedure evaluated through ictal frequency control. There is evidence that non-pharmacologic treatment of epilepsy has different effects on sleep patterns. Conclusion It is advisable to include objective and subjective sleep parameters in the initial evaluation and follow-up of patients considered for invasive procedures for epilepsy control, especially with VNS due to the risk of sleep apnoea. More high quality studies are needed.

25 citations


Cites background from "Effect of successful epilepsy surge..."

  • ...[32], 17 patients with refractory focal epilepsy, mostly of the mesial temporal type, followed by frontal and parietal, found a statistically significant reduction in ictal frequency (p = ....

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  • ...Zanzmera [32] Prospective cohort (III) 17 India Average 18....

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Journal ArticleDOI
TL;DR: It is concluded that patients with MTLE showed disrupted sleep architecture that may result in daytime dysfunction and sleep complaints and NREM sleep activated focal IEDs and them - when recorded during sleep - had higher localizing value.

23 citations

Journal ArticleDOI
TL;DR: Between sleep apneas and childhood epilepsy, there is a complex relationship with reciprocal interactions that should be taken into account when designing the management of these children, as it creates therapeutic opportunities and limitations.
Abstract: Our aim is to review studies which assess the prevalence of sleep apneas in children with epilepsy and discuss possible mechanisms linking these two conditions, as well as the impact of sleep apneas on the prognosis of these children. PubMed was used as the medical database source, and articles were selected and classified according to their originality, level of evidence, and relevance to the broad scope of the review. Children with epilepsy have a higher prevalence of sleep breathing disorders in comparison to healthy children, but this prevalence varies widely depending on the methodology of each study. Major risk factors for sleep apneas in childhood epilepsy include mainly poor seizure control and antiepileptic drug polytherapy. Indeed, epilepsy can trigger sleep apneas, as abnormal electrical discharge amplifies sleep-induced breathing instability, antiepileptic drugs disturb muscle tone, and vagus nerve stimulation modulates neurotransmission to airway muscles. On the other hand, sleep apneas enhance sleep fragmentation, thus reducing the threshold for the appearance of seizures. Moreover, they have a negative effect on the neurocognitive profile of these children, as they disturb neuroplasticity mechanisms and also have a probable association with sudden unexpected death in epilepsy. The surgical treatment of sleep apneas has been found to reduce seizure frequency, and this can offer new therapeutic choices. Between sleep apneas and childhood epilepsy, there is a complex relationship with reciprocal interactions. The presence of sleep apneas should be taken into account when designing the management of these children, as it creates therapeutic opportunities and limitations.

22 citations


Cites background from "Effect of successful epilepsy surge..."

  • ...[88] studied patients (adults and children) who underwent epilepsy surgery....

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  • ...Although the difference was not significant, it is also indicative of a possible association [88]....

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References
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Journal ArticleDOI
Murray W. Johns1
01 Nov 1991-Sleep
TL;DR: The development and use of a new scale, the Epworth sleepiness scale (ESS), is described, which is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness.
Abstract: The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.

13,788 citations

01 Jan 1993

2,670 citations

Book
01 Jan 1993
TL;DR: This work aims toward a surgical cure for epilepsy - the work of Wilder Penfield and his school at the Montreal Neurologic Institute, William Feindel.
Abstract: Prologue: toward a surgical cure for epilepsy - the work of Wilder Penfield and his school at the Montreal Neurologic Institute, William Feindel. Part 1 Identification of surgical candidates. Part 2 Non-invasive pre-operative evaluation. Part 3 Invasive pre-operative evaluation. Part 4 Surgical treatment. Part 5 Post-operative follow-up. Epilogue: general impressions of the past-present and future, Herbert H. Jasper. Appendices: historical perspectives, Jerome Engel Jr pre-surgical evaluation protocols guidelines for multi-centre research, B. Vickrey et al basic research in the setting of an epilepsy surgery centre, P. Schwartzkroin.

1,767 citations

Journal ArticleDOI
TL;DR: The contributors illustrate important new approaches to the assessment of human cognition in individuals with CNS disease that nonspecific behavioral descriptors such as ”word-finding difficulty” will soon be replaced by more meaningful characterizations that are theoretically motivated and therapeutically significant.
Abstract: ic (speech sound) encoding of the word in the context of an utterance. The first four chapters of the book investigate the ability to transform a message we are thinking to the word-forms required for i t s expression. Taken together, th i s section describes the process of moving from a concept to the selection of a lexical item, and provides a computer model for lemma retrieval that involves mental activation spreading from a triggered concept to the word-form stage. It appears that lemma retrieval obeys both semantic (meaning) and grammatical (structural) constraints available from the word‘s context, and that failures in lexical selection in pathologic states may be related to semantic or grammatical category effects. The next three chapters of the book are concerned with the phonetic realization of a word-form. Words themselves have a characteristic structure, and it appears that the structure of a word plays an important role in eliciting a speech error. Methodologic issues have restricted the nature of speech error analyses in normal subjects, and a critical examination of the aphasic speech error literature has additionally revealed that few investigators have examined error consistency in individual aphasics. Inconsistent speech error patterns in aphasia are unlikely to be due to the actual loss of phonologic information, but instead to the compromised transmission of information between processing subsystems. This book will be of most immediate interest to aphasiologists, but its significance for a much larger audience should not be lost. The contributors illustrate important new approaches to the assessment of human cognition in individuals with CNS disease. It is through the efforts of researchers such as these that nonspecific behavioral descriptors such as ”word-finding difficulty” will soon be replaced by more meaningful characterizations that are theoretically motivated and therapeutically significant.

364 citations

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Epilepsy surgery improves subjective sleep parameters in patients with medically refractory epilepsy during the early post operative period.