Genton P, Bureau M, Dravet C, Roger J
Centre Saint-Paul, Marseille, France.
Neurophysiol Clin. 1988 Aug;18(4):333-43. doi: 10.1016/s0987-7053(88)80090-x.
A nap sleep EEG with at least one full sleep cycle has been recorded in 3 groups of children free from diffuse encephalopathy and presenting with partial epilepsy with onset after the age of 3 years: 15 cases with typical benign epilepsy with centrorolandic spikes (BERS), 15 cases with partial symptomatic epilepsy without clinical or radiological evidence of a cerebral lesion, and 12 cases with partial epilepsy symptomatic of a proven cerebral lesion. The time course of paroxysmal abnormalities was quantified according to individual sleep stages; the number of foci was also quantified in the waking vs sleeping state. Paroxysmal abnormalities are significantly enhanced by sleep in all 3 groups: throughout sleep stages in BERS, in slow sleep stages only in the other groups. The enhancement is more striking in BERS, where a clear decrease of abnormalities is also found upon awakening. There is no major difference between the 2 symptomatic groups, with a greater enhancement of paroxysms in the proven lesional group. Contrary to the other groups, only the group including those patients with a documented cerebral lesion showed a significant increase in the number of foci during sleep: numerous foci were found in these patients that were distinct from the primary lesional focus. Under the conditions of our study, the nap EEG seems to provide an accurate evaluation of sleep-induced changes of paroxysmal activity in partial epilepsies of childhood.
对3组3岁以后发病的部分性癫痫患儿进行了记录，这些患儿均无弥漫性脑病：15例伴有中央颞区棘波的典型良性癫痫（BERS）、15例无脑部病变临床或影像学证据的部分症状性癫痫，以及12例有经证实的脑部病变的部分症状性癫痫。根据个体睡眠阶段对发作性异常的时间进程进行量化；还对清醒和睡眠状态下的病灶数量进行量化。在所有3组中，睡眠均显著增强发作性异常：在BERS组中整个睡眠阶段均增强，在其他组中仅在慢睡眠阶段增强。这种增强在BERS组中更为显著，在该组中觉醒时异常也明显减少。两个症状性组之间没有重大差异，在有证实病变的组中发作增强更为明显。与其他组相反，只有包括有记录脑部病变患者的组在睡眠期间病灶数量显著增加：在这些患者中发现了许多与原发性病变病灶不同的病灶。在我们的研究条件下，午睡脑电图似乎能准确评估儿童部分性癫痫中睡眠诱发的发作性活动变化。
