Autret A, de Toffol B, Corcia P, Hommet C, Prunier-Levilion C, Lucas B
Service de Neurologie-C.H.U., Tours 37044, Tours Cedex, France.
Sleep Med Rev. 1999 Sep;3(3):201-17. doi: 10.1016/s1087-0792(99)90002-3.
This review considers the effect of sleep on seizures and interictal electroencephalogram (EEG) paroxysmal activities (PAs), as classified by the International League Against Epilepsy criteria. No type of seizure is, per se, specifically linked with non-rapid eye movement (NREM) or rapid eye movement (REM) sleep. However, in some syndromes, seizures are more frequent in slow wave sleep (SWS) [partial motor or generalized seizure in benign epilepsy with centro-temporal spikes (BECTS), frontal seizures in idiopathic familial or not familial frontal lobe epilepsy and generalized tonic seizure in secondary generalized epilepsy are increased by SWS]. Conversely myoclonia and grand mal seizures are associated with awakening in some forms of generalized idiopathic epilepsy. There is a mean increase in PAs during SWS in generalized and in partial epilepsies on the whole. However, precise analysis shows that in partial cryptogenic or symptomatic epilepsy and, most likely, in the majority of generalized idiopathic epileptic syndromes about 20% of patients have an increase in PA density during SWS, 20% experience an increase in waking, 50% have very few PAs and in 10% there is no significant difference between sleep and waking. BECTS, however, exhibits a definite increase in sleep PA increase and in juvenile myoclonic epilepsy an increase in PAs during the intra-night awakening is reported. There are at least three syndromes, which cause a huge increase in PAs during sleep: the Landau-Kleffner syndrome and the syndromes of continuous focal or generalized spike-waves during SWS. Their physiopathology and neuropsychological consequences are discussed. Neurophysiological animal data are also reported highlighting the relationships between slow sleep oscillations and the generation of spike waves. A biochemical review is also presented.
本综述根据国际抗癫痫联盟的标准，探讨了睡眠对癫痫发作及发作间期脑电图（EEG）阵发性活动（PA）的影响。没有哪种癫痫发作类型本身与非快速眼动（NREM）睡眠或快速眼动（REM）睡眠有特定关联。然而，在某些综合征中，癫痫发作在慢波睡眠（SWS）中更为频繁[中央颞区棘波的良性癫痫中的部分运动性或全身性发作（BECTS）、特发性家族性或非家族性额叶癫痫中的额叶发作以及继发性全身性癫痫中的全身性强直发作在SWS时会增加]。相反，在某些全身性特发性癫痫形式中，肌阵挛和大发作与觉醒有关。总体而言，全身性和部分性癫痫在SWS期间PA平均增加。然而，精确分析表明，在部分隐源性或症状性癫痫中，很可能在大多数全身性特发性癫痫综合征中，约20%的患者在SWS期间PA密度增加，20%在清醒时增加，50%的患者PA很少，10%的患者睡眠和清醒之间无显著差异。然而，BECTS在睡眠时PA明显增加，据报道青少年肌阵挛癫痫在夜间觉醒期间PA增加。至少有三种综合征在睡眠期间会导致PA大幅增加：Landau-Kleffner综合征以及SWS期间持续性局灶性或全身性棘波-慢波综合征。讨论了它们的生理病理学和神经心理学后果。还报告了神经生理学动物数据，突出了慢睡眠振荡与棘波产生之间的关系。同时也进行了生化综述。
