Paroxysmal activity and seizures associated with sleep breathing disorder in children: A possible overlap between diurnal and nocturnal symptoms
Silvia Miano,Carmen Bachiller,Manuel Gutiérrez,Antonio Salcedo,Maria Pia Villa,Rosa Peraita-Adrados +5 more
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This study demonstrated a close relationship between pediatric SBD, PA during sleep, and epilepsy that may aggravate the prognosis of SBD.Abstract:
Purpose: Sleep breathing disorders (SBD) can trigger paroxysmal events. We recently found a higher percentage of paroxysmal activity (PA) in a sample of Italian children with obstructive sleep apnea syndrome (OSAS) and no history of epilepsy. The signs of nocturnal seizures can overlap with sleep respiratory events. The aim of this study was to confirm the high frequency of PA or interictal epileptiform discharges (IEDs) during sleep in a cohort of Spanish children who underwent polysomonography (PSG) for suspected SBD and to ascertain the eventual presence of seizures by means of a video-PSG with an extended electroencephalogram (EEG). Methods: PSG was performed in a population of children with no previous history of epileptic seizures recruited prospectively for suspected OSAS from January to December 2007. Recordings included at least 13 EEG channels. Results: In total, 25 children (mean age, 6.6 3.8 years, 14 males) were diagnosed with SBD, and 4/25 (16%) children met the criteria for OSAS and epilepsy, with IEDs and/or seizures during sleep. We diagnosed benign epilepsy with centro-temporal spikes in 2 cases, partial symptomatic epilepsy in one, and nocturnal frontal lobe epilepsy in another, while we found PA in 2 patients. The body mass index and the apnea–hypopnea index were significantly higher in children without IEDs/PA. Conclusions: Our study demonstrated a close relationship between pediatric SBD, PA during sleep, and epilepsy that may aggravate the prognosis of SBD. Due to the possibility of an overlap of symptoms, a video-PSG with extended EEG montage is necessary.read more
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Sleep clinical record: an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing
Maria Pia Villa,Maria Chiara Paolino,Rosa Castaldo,Nicola Vanacore,Alessandra Rizzoli,Silvia Miano,Marco Del Pozzo,Marilisa Montesano +7 more
TL;DR: A simple, PSG-validated tool to screen SDB, thus reducing the use of PSG, and may effectively be used to screen patients as candidates for PSG study for suspected OSA syndrome, and to enable those with a mild form of SDB to receive early treatment.
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Obstructive sleep apnea and other sleep-related syndromes.
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TL;DR: Treatment for obstructive sleep apnea syndrome includes continuous positive airway pressure and its variants, oral appliances, weight loss, upper airway surgery, and rarely maxillofacial procedures.
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Melatonin secretion in children with epilepsy
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The cooccurrence of interictal discharges and seizures in pediatric sleep-disordered breathing.
Silvia Miano,Alessandra Tabarrini,Ottavio Vitelli,Annamaria Mazzotta,Marco Del Pozzo,Jole Rabasco,Mario Barreto,Pasquale Parisi,Alessandro Ferretti,Maria Pia Villa +9 more
TL;DR: This study confirms the high prevalence of interictal epileptiform discharges in children with SDB and indicates that they may recede over time, accompanied by an improvement of sleep respiratory parameters.
References
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Journal Article
Psychiatric evaluation of children with CSWS (continuous spikes and waves during slow sleep) and BRE (benign childhood epilepsy with centrotemporal spikes/rolandic epilepsy) compared to children with absence epilepsy and healthy controls.
TL;DR: The findings suggest that CSWS and BRE are two epileptic syndromes that lead to psychiatric disorders and lower IQ scores and psychiatric consultation should be a part of the treatment while managing these children.