Halász Péter
Országos Klinikai Idegtudományi Intézet, Budapest.
Ideggyogy Sz. 2019 Sep 30;72(9-10):304-314. doi: 10.18071/isz.72.0304.
Aims - Overview of the new data about the strong link of sleep and epilepsy and conjoining cognitive impairment. Methods - Search for relevant references and summary of our own research activity on the topic. Results - Strong interrealtionship exists between epilepsy and plastic brain functions (memory processing and synaptic homeostasis) and the working modes of NREM sleep. In the most frequent childhood and adult epilepsy networks responsible for plastic functions can be derailed to an epileptic level of excitability, and suffer a transitory or permanent epileptic transformation. Exampling on the three big epilepsies: absence epilepsy; medial temporal lobe epilepsy; and childhood idiopathic focal age dependent epilepsy spectrum we demonstrate the most important features of this epileptic transformation. The association of cognitive impairment to certain sleep dependent epilepsies gains explanation by the epilepsy caused interference with slow wave decline (ICFE) and memory consolidation (MTLE) during NREM sleep. This paper serves also to introduce the concept of sleep dependent system epilepsies. Conclusions - We provide evidences about shared mechanisms among sleep related epilepsies being the derailment of sleep plastic funcions toward exaggerated excitability determined by the inherent possibilities of the signal transduction properties.
目的——概述有关睡眠与癫痫的紧密联系以及合并认知障碍的新数据。方法——检索相关参考文献并总结我们自身关于该主题的研究活动。结果——癫痫与大脑可塑性功能（记忆处理和突触稳态）以及非快速眼动睡眠的工作模式之间存在紧密的相互关系。在最常见的儿童和成人癫痫网络中，负责可塑性功能的网络可能会脱轨至癫痫性兴奋水平，并经历短暂或永久性的癫痫转变。以三种主要癫痫为例：失神癫痫；内侧颞叶癫痫；以及儿童特发性局灶性年龄依赖性癫痫谱系，我们展示了这种癫痫转变的最重要特征。认知障碍与某些睡眠依赖性癫痫的关联可通过癫痫在非快速眼动睡眠期间对慢波衰减（ICFE）和记忆巩固（MTLE）的干扰来解释。本文还旨在介绍睡眠依赖性系统癫痫的概念。结论——我们提供了证据，表明睡眠相关癫痫之间存在共同机制，即睡眠可塑性功能因信号转导特性的内在可能性而脱轨至过度兴奋状态。
