Nobili L, Baglietto M G, Beelke M, De Carli F, De Negri E, Tortorelli S, Ferrillo F
Child Neuropsychiatry, DSN, Gaslini Institute, Genoa, Italy.
Epilepsia. 2000 Feb;41(2):201-6. doi: 10.1111/j.1528-1157.2000.tb00140.x.
Landau-Kleffner syndrome (LKS) is characterized by a marked increase of interictal epileptiform discharges (IEDs) during sleep. During nonrapid eye movement (NREM) sleep, neuronal membrane potential oscillations lead to the appearance of spindles and delta waves in the surface EEG and might develop into paroxysmal synchronization. Spectral analysis allows the quantitative description of the dynamics of delta (slow-wave activity, SWA, 0.5-4.5 Hz) and sigma activity (SA, 12.0-16.0 Hz) and can be used to assess the relation between SA, SWA, and IEDs during sleep.
We performed six overnight continuous EEG-polysomnographic studies in three patients with LKS. The temporal series of SWA and SA were obtained from a spike-free derivation lead. The IEDs count was performed on the most active lead. Relations between sigma and SWA and time series of IEDs were tested by means of correlation techniques after data normalization.
Our results revealed a significantly higher correlation between IEDs and SA with respect to SWA in all the subjects, in total sleep time. The same analysis limited to NREM sleep highlights the better correlation between SA and IEDs.
Our data suggest that neural mechanisms involved in the generation of sleep spindles facilitate IEDs production in LKS.
Landau-Kleffner综合征（LKS）的特征是睡眠期间发作间期癫痫样放电（IEDs）显著增加。在非快速眼动（NREM）睡眠期间，神经元膜电位振荡导致表面脑电图中出现纺锤波和δ波，并可能发展为阵发性同步。频谱分析可以对δ波（慢波活动，SWA，0.5 - 4.5Hz）和σ活动（SA，12.0 - 16.0Hz）的动态进行定量描述，并可用于评估睡眠期间SA、SWA和IEDs之间的关系。
我们对3例LKS患者进行了6次整夜连续脑电图-多导睡眠图研究。SWA和SA的时间序列取自无棘波的导联。在最活跃的导联上进行IEDs计数。数据标准化后，通过相关技术测试σ波和SWA之间的关系以及IEDs的时间序列。
我们的结果显示，在所有受试者的总睡眠时间内，IEDs与SA之间的相关性显著高于与SWA的相关性。仅限于NREM睡眠的相同分析突出了SA与IEDs之间更好的相关性。
我们的数据表明，参与睡眠纺锤波产生的神经机制促进了LKS中IEDs的产生。
