Khachatryan S G, Tunyan Yu S
Mkhitar Heratsi Erevan State Medical University, Erevan, Armenia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(9. Vyp. 2):88-94. doi: 10.17116/jnevro20171179288-94.
In this review, the authors discuss the problem of management of the patient with epilepsy with regard an impact of epileptic seizures and syndromes on sleep structure. Sleep disorders can lead to worsening of seizure control and general medical condition of the patients. However, seizures themselves and types of epilepsy can affect the sleep architecture. One of the most frequent symptoms of disordered sleep in epilepsy patients is excessive daytime sleepiness, which can be a consequence of poor sleep quality due to frequent nocturnal seizures or excessive interictal epileptiform activity during sleep leading to frequent arousals. is frequently referred to antiepileptic drug side effects. In patients with frontal and temporal lobe epilepsies, which are more associated with sleep, the sleep architecture is significantly different from healthy individuals. They have more frequent arousals, disturbed relationship between sleep phases and stages, in particular inhibited REM-sleep phase. Most recent data on this problem are reviewed. Sleep patterns for different major epileptic syndromes are presented and some general recommendations for patient management, with a special consideration of sleep issues, are given.
在本综述中,作者探讨了癫痫患者的管理问题,涉及癫痫发作和综合征对睡眠结构的影响。睡眠障碍可导致患者癫痫控制情况恶化以及整体健康状况变差。然而,癫痫发作本身及癫痫类型会影响睡眠结构。癫痫患者睡眠紊乱最常见的症状之一是日间过度嗜睡,这可能是由于夜间频繁发作导致睡眠质量差,或睡眠期间发作间期癫痫样活动过多导致频繁觉醒所致。这常被归因于抗癫痫药物的副作用。在与睡眠关联更大的额叶和颞叶癫痫患者中,其睡眠结构与健康个体显著不同。他们觉醒更频繁,睡眠阶段和时期之间的关系紊乱,尤其是快速眼动睡眠期受到抑制。本文回顾了关于该问题的最新数据。介绍了不同主要癫痫综合征的睡眠模式,并给出了一些针对患者管理的一般性建议,其中特别考虑了睡眠问题。