Fröscher W
Neurologische Abteilung, Psychiatrisches Landeskrankenhaus Weissenau, Ravensburg-Weissenau, F.R.G.
Epilepsy Res Suppl. 1991;2:165-76.
The correlations between sleep and prolonged epileptic activity are discussed on the basis of the status classification of Gastaut (1983). Little information is available on the interrelation of sleep and the status of tonic-clonic seizures (grand mal status). Most important is the therapeutical management of these cases. Tonic seizures have been reported to occur in large numbers during NREM sleep in patients with Lennox-Gastaut syndrome. A status-like increase is possible. Tonic seizures occur almost exclusively during sleep. Myoclonic status epilepticus arising (a) in the course of primary generalized epilepsy and (b) in the course of encephalopathies, are usually markedly attenuated during sleep. In absence status (petit mal status) synchronized sleep generally fragments the continuous discharge which is replaced by isolated bursts of polyspikes, or polyspike and wave complexes. The absence status can recur upon awaking during the night or in the morning. The abnormal EEG activity of a petit mal status can, however, occasionally persist during the whole night. Improvement as well as activation during sleep have been observed in elementary (= simple) partial status epilepticus; improvement seems to be more frequent. Epilepsia partialis continua may persist or decrease during sleep. An increase as well as decrease of motor phenomena has been observed during the REM stages. 'Epileptic aphasia' of childhood is associated with subclinical bioelectric status epilepticus during sleep. The electrical status epilepticus must be delineated as a separate group. The term encephalopathy related to electrical status epilepticus during slow sleep (ESES) has been proposed on the basis of associated psychic syndromes. This form of status epilepticus disappears during the waking state and during REM sleep. Cases with hypsarrhythmia without clinical signs may also be classified under the group of electrical or bioelectrical status. In some cases, a continuous hypsarrhythmia is observed only during sleep. In this context, one must also mention those patients who demonstrate continuous activation of spikes, or spike and wave potentials (without clinical seizures) during eye closure.
基于加斯陶（1983年）的状态分类，探讨了睡眠与癫痫持续活动之间的相关性。关于睡眠与强直阵挛性发作（癫痫大发作状态）状态之间的相互关系，目前所知甚少。这些病例最重要的是治疗管理。据报道，在Lennox-Gastaut综合征患者的非快速眼动睡眠期间会大量出现强直发作。可能会出现类似癫痫持续状态的增加。强直发作几乎只在睡眠期间发生。在原发性全身性癫痫过程中以及（b）在脑病过程中出现的肌阵挛性癫痫持续状态，在睡眠期间通常会明显减轻。在失神状态（癫痫小发作状态）中，同步睡眠通常会使持续放电中断，取而代之的是孤立的多棘波爆发或多棘波和慢波复合波。夜间或早晨醒来时失神状态可能会复发。然而，癫痫小发作状态的异常脑电图活动偶尔可能会持续一整晚。在单纯部分性癫痫持续状态中，观察到睡眠期间有改善以及激活；改善似乎更常见。持续性部分性癫痫在睡眠期间可能持续或减轻。在快速眼动阶段观察到运动现象有增加也有减少。儿童期的“癫痫性失语”与睡眠期间的亚临床生物电癫痫持续状态有关。电癫痫持续状态必须被划定为一个单独的组。基于相关的精神综合征，有人提出了与慢睡眠期间电癫痫持续状态相关的脑病（ESES）这一术语。这种癫痫持续状态形式在清醒状态和快速眼动睡眠期间消失。无临床体征的高峰节律紊乱病例也可归类于电或生物电状态组。在某些情况下，仅在睡眠期间观察到持续的高峰节律紊乱。在这种情况下，还必须提到那些在闭眼时表现出棘波或棘慢波电位持续激活（无临床发作）的患者。
