Natteru Prashant, Rupareliya Chintan, Zhou Xiangping, Bollu Pradeep C
Department of Neurology, University of Mississippi Medical Center.
Department of Neurology, University of Missouri, Columbia, Missouri.
Cureus. 2017 Oct 24;9(10):e1800. doi: 10.7759/cureus.1800.
Obstructive sleep apnea (OSA), an increasingly prevalent sleep disorder, has been extensively studied in both clinical and scientific settings. In most cases, the diagnosis of sleep apnea is straightforward with patients having symptoms of snoring, choking or gasping for air while asleep and witnessed apneas. However, sleep apnea is known to present in some unusual ways. We present a case of a 61-year-old male, with recently diagnosed obstructive sleep apnea (currently not on continuous positive airway pressure (CPAP)) and a history of seizure-like events since the age of 18 years, who came to the epilepsy monitoring unit (EMU) for spell characterization of his frequent seizure-like episodes. A continuous video electroencephalogram (vEEG) performed in order to determine the semiology of these spells showed that all the spells were triggered by an arousal from sleep with an associated apneic event. He was started on positive airway pressure (PAP) therapy, which resulted in the gradual decline in the number as well as the severity of his seizure-like spells. Based on the observations from vEEG monitoring and the patient's response, we concluded these seizure-like events as non-epileptic spells, triggered by apnea-related arousals in the context of OSA.
阻塞性睡眠呼吸暂停（OSA）是一种日益普遍的睡眠障碍，在临床和科研环境中都得到了广泛研究。在大多数情况下，睡眠呼吸暂停的诊断很简单，患者有打鼾、窒息或睡觉时喘气的症状，并有呼吸暂停的目击情况。然而，已知睡眠呼吸暂停会以一些不寻常的方式出现。我们报告一例61岁男性病例，他最近被诊断为阻塞性睡眠呼吸暂停（目前未使用持续气道正压通气（CPAP）），自18岁起有癫痫样发作史，他来到癫痫监测单元（EMU）对其频繁的癫痫样发作进行发作特征描述。为了确定这些发作的症状学表现而进行的连续视频脑电图（vEEG）显示，所有发作均由睡眠觉醒及相关的呼吸暂停事件触发。他开始接受气道正压通气（PAP）治疗，这导致他癫痫样发作的次数和严重程度逐渐下降。基于vEEG监测的观察结果和患者的反应，我们将这些癫痫样事件判定为非癫痫性发作，是在OSA背景下由呼吸暂停相关的觉醒触发的。
