Capdevila Oscar Sans, Dayyat Ehab, Kheirandish-Gozal Leila, Gozal David
Kosair Children's Hospital Sleep Medicine and Apnea Center, Department of Pediatrics, University of Louisville, 570 South Preston Street, Suite 204, Louisville, KY 40202, USA.
Sleep Med. 2008 Mar;9(3):303-9. doi: 10.1016/j.sleep.2007.03.024. Epub 2007 Jul 16.
The term epileptiform discharge typically refers to interictal paroxysmal activity that occurs more commonly during sleep. This type of paroxysmal activity does not include the electroencephalographic (EEG) activity observed during a seizure. The prevalence of epileptiform activity in the general pediatric population is unknown.
Polysomnographic (PSG) studies were conducted in otherwise healthy children recruited from the general population and with no previous history of seizures or any other medical conditions. All sleep studies included an eight-lead EEG montage. Spike and sharp waves, either alone or accompanied by slow waves, occurring singly or in bursts lasting <5s were considered as representing epileptiform activity.
Nine hundred seventy children underwent overnight PSG. In 14 children, evidence of epileptiform activity, in the absence of any additional abnormality in the PSG, occurred. Thus, the prevalence of epileptiform activity was 1.45%. Epileptiform patterns found were either spike or spike and wave and were more prominent during non-rapid eye movement (NREM) sleep, with 11 patients presenting spike and spike and wave patterns in the centro-temporal regions. Four of the six children who underwent neurocognitive tests exhibited abnormal findings in areas of behavior, attention, hyperactivity, and learning.
Epileptiform activity in otherwise healthy children from the community is relatively frequent and, if confirmed by prospective studies, could be associated with suboptimal cognitive and behavioral functions. Increased awareness by sleep professionals and use of PSG montage that includes temporal leads and >2 standard EEG leads should facilitate the detection of epileptiform activity in children.
癫痫样放电这一术语通常指发作间期的阵发性活动，这种活动在睡眠期间更为常见。此类阵发性活动不包括癫痫发作期间观察到的脑电图（EEG）活动。普通儿科人群中癫痫样活动的患病率尚不清楚。
对从普通人群中招募的、既往无癫痫发作史或任何其他疾病史的健康儿童进行多导睡眠图（PSG）研究。所有睡眠研究均包括八导EEG监测。单独出现或伴有慢波、单个或成串出现且持续时间<5秒的棘波和尖波被视为代表癫痫样活动。
970名儿童接受了整夜PSG检查。在14名儿童中，发现了癫痫样活动的证据，且PSG无任何其他异常。因此，癫痫样活动的患病率为1.45%。发现的癫痫样模式为棘波或棘慢波，在非快速眼动（NREM）睡眠期间更为突出，11名患者在中央颞区出现棘波和棘慢波模式。接受神经认知测试的6名儿童中有4名在行为、注意力、多动和学习方面表现出异常结果。
社区中健康儿童的癫痫样活动相对常见，若前瞻性研究得以证实，可能与认知和行为功能欠佳有关。睡眠专业人员提高认识并使用包括颞部导联和>2个标准EEG导联的PSG监测，应有助于检测儿童的癫痫样活动。
