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无精神疾病和慢性精神疾病的癫痫患者的睡眠-觉醒节律与癫痫发作频率

Sleeping-waking rhythm and frequency of seizures in epilepsy without psychoses and with chronic psychoses.

作者信息

Boldyrev A I, Pozdnyakov V S

出版信息

Neurosci Behav Physiol. 1985 Nov-Dec;15(6):451-5. doi: 10.1007/BF01184252.

DOI:10.1007/BF01184252
PMID:4094675
Abstract

Sleeping-waking is a basic biological rhythm. A study of sleep in epilepsy established that changes in the EEG vary with different sleep phases. Activation of epileptic electroencephalographic phenomena was observed more frequently during NREM (non-rapid eye movement) phases; the REM, or paradoxical, sleep phase seemed to inhibit such phenomena. On this basis some authors are attempting far-reaching conclusions concerning a connection between separate sleep phases and the development of epileptic seizures. To a certain degree, a similar interpretation is focusing on the problem of the relationship of seizures and their frequency to the sleeping-waking rhythm. In this connection, it must be noted that in themselves EEG changes and epilepsy, a disease in which convulsive episodes play a substantial role, are not identical. Horyd and Baransia-Teruszak found no reliable correlation between EEG changes and type of seizure. There was a correlation between frequency of seizures and the electroencephalographic picture in only 30% of the cases. The authors believe that in the remaining 70% the connection between EEG shifts and clinical manifestations of epilepsy is more complex. On the other hand, as N. N. Bemin et al. indicated, based on hypotheses developed by N. P. Bekhtereva on "flexible" and "rigid" connection, sleep is one of the processes that is regulated by flexible connections and for this reason the sequence and duration of sleep phases is exceptionally variable and depends on most various external and internal factors.

摘要

睡眠-觉醒是一种基本的生物节律。一项关于癫痫患者睡眠的研究表明,脑电图(EEG)的变化随不同睡眠阶段而不同。在非快速眼动(NREM)阶段,癫痫性脑电图现象的激活更为频繁;快速眼动(REM)睡眠阶段,即异相睡眠阶段,似乎会抑制此类现象。基于此,一些作者试图就不同睡眠阶段与癫痫发作的发展之间的联系得出深远的结论。在一定程度上,类似的解释聚焦于癫痫发作及其频率与睡眠-觉醒节律的关系问题。在这方面,必须指出的是,脑电图变化本身与癫痫(一种惊厥发作起重要作用的疾病)并不等同。霍里德和巴兰西亚-特鲁扎克发现脑电图变化与癫痫发作类型之间没有可靠的相关性。仅在30%的病例中,癫痫发作频率与脑电图表现之间存在相关性。作者认为,在其余70%的病例中,脑电图变化与癫痫临床表现之间的联系更为复杂。另一方面,正如N. N. 别缅等人所指出的,基于N. P. 别赫捷列娃提出的关于“灵活”和“刚性”联系的假说,睡眠是由灵活联系调节的过程之一,因此睡眠阶段的顺序和持续时间异常多变,取决于各种各样的外部和内部因素。

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