Department of Clinical and Experimental Epilepsy, National Hospital for Neurology and Neurosurgery, UCL Institute of Neurology, London, UK.
Curr Opin Neurol. 2011 Apr;24(2):171-6. doi: 10.1097/WCO.0b013e3283445355.
There is a complex relationship between epilepsy, sleep and sleep disorders. Recent studies have provided new insights into the links between the disorders that may facilitate differential diagnosis and treatment but may also improve our understanding of underlying pathophysiological mechanisms.
Sleep and sleep deprivation have long been recognized to influence interictal epileptiform discharges and seizures. More recent studies have shown that primary sleep disorders such as obstructive sleep apnoea may worsen epilepsy and treatment of these sleep disorders can lead to improved seizure control. Seizures may interfere with night-time sleep structure and cause excessive day-time somnolence (EDS). Antiepileptic drugs may also cause EDS or influence sleep. Despite more frequent use of video-electroencephalographic telemetry and polysomnography, the differential diagnostic challenges between nonrapid eye movement parasomnia and nocturnal frontal lobe epilepsy remain. There is also ongoing debate regarding the possibility of a common pathogenic background for parasomnias and nocturnal seizures that is summarized in the review.
Accurate identification and diagnosis of sleep disorders as well as epilepsy is clinically important to ensure optimal treatment of both epilepsy and sleep disorders. Further studies of these nocturnal events may advance our understanding of underlying pathological mechanisms and the complex relationship between sleep and epilepsy.
综述目的：癫痫、睡眠和睡眠障碍之间存在着复杂的关系。最近的研究为这些疾病之间的联系提供了新的见解，这可能有助于鉴别诊断和治疗，但也可能加深我们对潜在病理生理机制的理解。
最新发现：睡眠和睡眠剥夺早已被认为会影响发作间期癫痫样放电和癫痫发作。最近的研究表明，阻塞性睡眠呼吸暂停等原发性睡眠障碍可能会使癫痫恶化，治疗这些睡眠障碍可以改善癫痫发作的控制。癫痫发作可能会干扰夜间睡眠结构，导致日间过度嗜睡（EDS）。抗癫痫药物也可能引起 EDS 或影响睡眠。尽管越来越频繁地使用视频脑电图遥测和多导睡眠图，但非快速眼动性睡眠障碍与夜间额叶癫痫之间的鉴别诊断挑战仍然存在。关于睡眠障碍和夜间发作可能存在共同致病背景的争论仍在继续，综述中对此进行了总结。
总结：准确识别和诊断睡眠障碍以及癫痫在临床上非常重要，以确保癫痫和睡眠障碍的最佳治疗。对这些夜间事件的进一步研究可能会增进我们对潜在病理生理机制以及睡眠与癫痫之间复杂关系的理解。
