EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy
Seizures in Juvenile Myoclonic Epilepsy (JME) are dependent on the sleep-wake cycle and precipitant factors, among which sleep deprivation (SD) is one of the most important. Still an under diagnosed syndrome, misinterpretation of the EEGs contributes to diagnostic delay. Despite this, a quantitative EEG investigation of SD effects has not been performed. We investigated the effect of SD on EEGs in 41 patients, aged 16-50 yr. (mean 25.4), who had not yet had syndromic diagnosis after a mean delay of 8.2 yr. Two EEG recordings separated by a 48-hour interval were taken at 7 a.m. preceded by a period of 6 hours of sleep (routine EEG) and after SD (sleep-deprived EEG). The same protocol was followed and included a rest wakefulness recording, photic stimulation, hyperventilation and a post-hyperventilation period. The EEGs were analyzed as to the effect of SD on the number, duration, morphology, localization and predominance of abnormalities in the different stages. A discharge index (DI) was calculated. Out of the 41 patients, 4 presented both normal EEG recordings. In 37 (90.2%) there were epileptiform discharges (ED). The number of patients with ED ascended from 26 (70.3%) in the routine EEG to 32 (86.5%) in the sleep-deprived exam. The presence of generalized spike-wave and multispike-wave increased from 20 (54.1%) and 13 (35.1%) in the first EEG to 29 (78.4%) and 19 (51.4%) in the second, respectively (p<0.05 and p<0.01). As to localization, the number of generalized, bilateral and synchronous ED increased from 21 (56.8%) to 30 (81.1%) (p<0.01). The DI also increased; while 8 patients (21.6%) presented greater rate in the routine EEG, 25 (67.6%) did so in the sleep-deprived EEG mainly during somnolence and sleep (p<0.01). Moreover, the paroxysms were also longer in the sleep-deprived EEG. Sleep-deprived EEG is a powerful tool in JME and can contribute significantly to the syndromic characterization of this syndrome.
| Main Authors: | , , , , , |
|---|---|
| Format: | Digital revista |
| Language: | English |
| Published: |
Academia Brasileira de Neurologia - ABNEURO
2005
|
| Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2005000300003 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| id |
oai:scielo:S0004-282X2005000300003 |
|---|---|
| record_format |
ojs |
| spelling |
oai:scielo:S0004-282X20050003000032005-07-25EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsySousa,Nise Alessandra de CarvalhoSousa,Patrícia da SilvaGarzon,ElianaSakamoto,Américo C.Braga,Nádia I.O.Yacubian,Elza Márcia Targas sleep deprivation EEG diagnosis juvenile myoclonic epilepsy Seizures in Juvenile Myoclonic Epilepsy (JME) are dependent on the sleep-wake cycle and precipitant factors, among which sleep deprivation (SD) is one of the most important. Still an under diagnosed syndrome, misinterpretation of the EEGs contributes to diagnostic delay. Despite this, a quantitative EEG investigation of SD effects has not been performed. We investigated the effect of SD on EEGs in 41 patients, aged 16-50 yr. (mean 25.4), who had not yet had syndromic diagnosis after a mean delay of 8.2 yr. Two EEG recordings separated by a 48-hour interval were taken at 7 a.m. preceded by a period of 6 hours of sleep (routine EEG) and after SD (sleep-deprived EEG). The same protocol was followed and included a rest wakefulness recording, photic stimulation, hyperventilation and a post-hyperventilation period. The EEGs were analyzed as to the effect of SD on the number, duration, morphology, localization and predominance of abnormalities in the different stages. A discharge index (DI) was calculated. Out of the 41 patients, 4 presented both normal EEG recordings. In 37 (90.2%) there were epileptiform discharges (ED). The number of patients with ED ascended from 26 (70.3%) in the routine EEG to 32 (86.5%) in the sleep-deprived exam. The presence of generalized spike-wave and multispike-wave increased from 20 (54.1%) and 13 (35.1%) in the first EEG to 29 (78.4%) and 19 (51.4%) in the second, respectively (p<0.05 and p<0.01). As to localization, the number of generalized, bilateral and synchronous ED increased from 21 (56.8%) to 30 (81.1%) (p<0.01). The DI also increased; while 8 patients (21.6%) presented greater rate in the routine EEG, 25 (67.6%) did so in the sleep-deprived EEG mainly during somnolence and sleep (p<0.01). Moreover, the paroxysms were also longer in the sleep-deprived EEG. Sleep-deprived EEG is a powerful tool in JME and can contribute significantly to the syndromic characterization of this syndrome.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia - ABNEUROArquivos de Neuro-Psiquiatria v.63 n.2b 20052005-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2005000300003en10.1590/S0004-282X2005000300003 |
| institution |
SCIELO |
| collection |
OJS |
| country |
Brasil |
| countrycode |
BR |
| component |
Revista |
| access |
En linea |
| databasecode |
rev-scielo-br |
| tag |
revista |
| region |
America del Sur |
| libraryname |
SciELO |
| language |
English |
| format |
Digital |
| author |
Sousa,Nise Alessandra de Carvalho Sousa,Patrícia da Silva Garzon,Eliana Sakamoto,Américo C. Braga,Nádia I.O. Yacubian,Elza Márcia Targas |
| spellingShingle |
Sousa,Nise Alessandra de Carvalho Sousa,Patrícia da Silva Garzon,Eliana Sakamoto,Américo C. Braga,Nádia I.O. Yacubian,Elza Márcia Targas EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy |
| author_facet |
Sousa,Nise Alessandra de Carvalho Sousa,Patrícia da Silva Garzon,Eliana Sakamoto,Américo C. Braga,Nádia I.O. Yacubian,Elza Márcia Targas |
| author_sort |
Sousa,Nise Alessandra de Carvalho |
| title |
EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy |
| title_short |
EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy |
| title_full |
EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy |
| title_fullStr |
EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy |
| title_full_unstemmed |
EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy |
| title_sort |
eeg recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy |
| description |
Seizures in Juvenile Myoclonic Epilepsy (JME) are dependent on the sleep-wake cycle and precipitant factors, among which sleep deprivation (SD) is one of the most important. Still an under diagnosed syndrome, misinterpretation of the EEGs contributes to diagnostic delay. Despite this, a quantitative EEG investigation of SD effects has not been performed. We investigated the effect of SD on EEGs in 41 patients, aged 16-50 yr. (mean 25.4), who had not yet had syndromic diagnosis after a mean delay of 8.2 yr. Two EEG recordings separated by a 48-hour interval were taken at 7 a.m. preceded by a period of 6 hours of sleep (routine EEG) and after SD (sleep-deprived EEG). The same protocol was followed and included a rest wakefulness recording, photic stimulation, hyperventilation and a post-hyperventilation period. The EEGs were analyzed as to the effect of SD on the number, duration, morphology, localization and predominance of abnormalities in the different stages. A discharge index (DI) was calculated. Out of the 41 patients, 4 presented both normal EEG recordings. In 37 (90.2%) there were epileptiform discharges (ED). The number of patients with ED ascended from 26 (70.3%) in the routine EEG to 32 (86.5%) in the sleep-deprived exam. The presence of generalized spike-wave and multispike-wave increased from 20 (54.1%) and 13 (35.1%) in the first EEG to 29 (78.4%) and 19 (51.4%) in the second, respectively (p<0.05 and p<0.01). As to localization, the number of generalized, bilateral and synchronous ED increased from 21 (56.8%) to 30 (81.1%) (p<0.01). The DI also increased; while 8 patients (21.6%) presented greater rate in the routine EEG, 25 (67.6%) did so in the sleep-deprived EEG mainly during somnolence and sleep (p<0.01). Moreover, the paroxysms were also longer in the sleep-deprived EEG. Sleep-deprived EEG is a powerful tool in JME and can contribute significantly to the syndromic characterization of this syndrome. |
| publisher |
Academia Brasileira de Neurologia - ABNEURO |
| publishDate |
2005 |
| url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2005000300003 |
| work_keys_str_mv |
AT sousanisealessandradecarvalho eegrecordingaftersleepdeprivationinaseriesofpatientswithjuvenilemyoclonicepilepsy AT sousapatriciadasilva eegrecordingaftersleepdeprivationinaseriesofpatientswithjuvenilemyoclonicepilepsy AT garzoneliana eegrecordingaftersleepdeprivationinaseriesofpatientswithjuvenilemyoclonicepilepsy AT sakamotoamericoc eegrecordingaftersleepdeprivationinaseriesofpatientswithjuvenilemyoclonicepilepsy AT braganadiaio eegrecordingaftersleepdeprivationinaseriesofpatientswithjuvenilemyoclonicepilepsy AT yacubianelzamarciatargas eegrecordingaftersleepdeprivationinaseriesofpatientswithjuvenilemyoclonicepilepsy |
| _version_ |
1756374302766137344 |