Department of Pediatrics, Sleep Disease Centre, University of Rome La Sapienza-S Andrea Hospital, Rome, Italy.
Seizure. 2010 Nov;19(9):547-52. doi: 10.1016/j.seizure.2010.07.015. Epub 2010 Aug 21.
Sleep breathing disorders (SBD) can trigger paroxysmal events. We recently found a higher percentage of paroxysmal activity (PA) in a sample of Italian children with obstructive sleep apnea syndrome (OSAS) and no history of epilepsy. The signs of nocturnal seizures can overlap with sleep respiratory events. The aim of this study was to confirm the high frequency of PA or interictal epileptiform discharges (IEDs) during sleep in a cohort of Spanish children who underwent polysomonography (PSG) for suspected SBD and to ascertain the eventual presence of seizures by means of a video-PSG with an extended electroencephalogram (EEG).
PSG was performed in a population of children with no previous history of epileptic seizures recruited prospectively for suspected OSAS from January to December 2007. Recordings included at least 13 EEG channels.
In total, 25 children (mean age, 6.6 ± 3.8 years, 14 males) were diagnosed with SBD, and 4/25 (16%) children met the criteria for OSAS and epilepsy, with IEDs and/or seizures during sleep. We diagnosed benign epilepsy with centro-temporal spikes in 2 cases, partial symptomatic epilepsy in one, and nocturnal frontal lobe epilepsy in another, while we found PA in 2 patients. The body mass index and the apnea-hypopnea index were significantly higher in children without IEDs/PA.
Our study demonstrated a close relationship between pediatric SBD, PA during sleep, and epilepsy that may aggravate the prognosis of SBD. Due to the possibility of an overlap of symptoms, a video-PSG with extended EEG montage is necessary.
睡眠呼吸障碍（SBD）可引发阵发性事件。我们最近发现，在一组无癫痫病史的意大利阻塞性睡眠呼吸暂停综合征（OSAS）患儿样本中，阵发性活动（PA）的比例较高。夜间发作的迹象可能与睡眠呼吸事件重叠。本研究的目的是确认在一组因疑似 SBD 而行多导睡眠图（PSG）检查的西班牙儿童中，睡眠期间 PA 或发作间癫痫样放电（IEDs）的高频，通过视频 PSG 结合延长脑电图（EEG）确定是否存在癫痫发作。
对 2007 年 1 月至 12 月期间因疑似 OSAS 而前瞻性招募的无癫痫发作史的儿童进行 PSG。记录至少包括 13 个 EEG 通道。
共 25 名儿童（平均年龄 6.6±3.8 岁，14 名男性）被诊断为 SBD，4/25（16%）名儿童符合 OSAS 和癫痫的标准，存在睡眠期间的 IEDs 和/或癫痫发作。我们诊断了 2 例良性癫痫伴中央颞区棘波、1 例部分症状性癫痫和 1 例夜间额叶癫痫，而我们在 2 例患者中发现了 PA。无 IED/PA 的儿童的体重指数和呼吸暂停低通气指数显著较高。
我们的研究表明，儿科 SBD、睡眠期间的 PA 和癫痫之间存在密切关系，这可能会使 SBD 的预后恶化。由于症状可能重叠，需要进行视频 PSG 并延长 EEG 导联。
