Neurological Institute, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
Epileptic Disord. 2010 Dec;12(4):270-4. doi: 10.1684/epd.2010.0336. Epub 2010 Oct 29.
The relationship between epilepsy and sleep is complex and bidirectional. Ictal awakening is probably a common and well-described phenomenon. In this small observational study we describe arousal from sleep as the only, or at least main, manifestation of some epileptic seizures. We coin the term "hypnopompic seizures" to describe this entity. Five patients with intractable epilepsy were monitored by continuous video-electroencephalogram. Four of them had left temporal lobe epilepsy and one patient had generalised epilepsy. Hypnopompic seizures accounted for 30-100% of their seizure types captured during monitoring. All the seizures occurred during stage II sleep and were brief. Hypnopompic seizures are extremely subtle and may be underdiagnosed and underreported. Future larger studies are needed to shed some light on this unique entity and its neuropathophysiology. Epileptologists should be aware of this type of seizure and careful review of electroencephalograms during the transition from sleep to arousal is imperative to capture these seizures. Physicians, patients and families also need to be aware of such a subtle manifestation of seizures. Improved awareness of hypnopompic seizures and subtle seizures, in general, help guide accurate and early diagnosis, thorough monitoring and appropriate management.
癫痫与睡眠之间的关系复杂且相互影响。发作性觉醒可能是一种常见且已有充分描述的现象。在这项小型观察性研究中，我们将睡眠中觉醒作为某些癫痫发作的唯一或至少主要表现来描述。我们将这种现象命名为“催眠期发作”。5 名耐药性癫痫患者接受了连续视频脑电图监测。其中 4 名患者为左侧颞叶癫痫，1 名患者为全面性癫痫。在监测期间，催眠期发作占他们所捕捉到的发作类型的 30-100%。所有发作均发生在睡眠第二期，且持续时间短暂。催眠期发作极为细微，可能被漏诊和低估。未来需要进行更大规模的研究，以阐明这一独特实体及其神经病理生理学机制。癫痫学家应意识到这种类型的发作，在从睡眠向觉醒过渡期间仔细复查脑电图对于捕捉这些发作至关重要。医生、患者和家属也需要意识到这种细微的癫痫发作表现。提高对催眠期发作和一般细微发作的认识有助于指导准确、早期诊断、全面监测和适当管理。
