Silvestri R, de Domenico P, Mento G, Laganà A, di Perri R
Clinica Neurologica I, Università di Messina, Italy.
Neurophysiol Clin. 1995;25(1):19-27. doi: 10.1016/0987-7053(96)81031-8.
Six patients (3M, 3F, mean age 17.3 yrs) presenting different types of evolution from disorders of arousal to epilepsy are described. All subjects during their childhood had been diagnosed in a sleep center as affected by sleep-walking (three cases) and night terrors (the other three). Successively they developed nocturnal events different from those previously exhibited and consisting of clear epileptic seizures, generalized tonic-clonic in one case and complex partial in five cases. Nocturnal monitoring allowed recognition of clear interictal paroxysmal activity in three patients, while ictal events were recorded in the remaining three. Anticonvulsant treatment (carbamazepine in five patients, phenytoin in one patient) led to the resolution of the ictal events in all cases. The fact that both disorders of arousal and epilepsy are strictly related to sleep and often share common features such as age range of onset and precipitating factors, suggests the existence of common functional substrates identifiable in constitutional maturative and biologic factors. The possible occurrence of seizures in subjects exhibiting parasomnia during their childhood has to be considered in patients with familial history of epilepsy and in all doubtful cases.
本文描述了6例（3男，3女，平均年龄17.3岁）从觉醒障碍演变为癫痫的不同类型病例。所有受试者在儿童时期均在睡眠中心被诊断为患有梦游症（3例）和夜惊症（另外3例）。随后，他们出现了与之前不同的夜间发作，表现为明确的癫痫发作，其中1例为全身强直阵挛发作，5例为复杂部分性发作。夜间监测发现3例患者有明确的发作间期阵发性活动，其余3例记录到了发作期事件。抗惊厥治疗（5例患者使用卡马西平，1例患者使用苯妥英钠）使所有病例的发作期事件得到缓解。觉醒障碍和癫痫都与睡眠密切相关，且往往具有共同特征，如发病年龄范围和诱发因素，这表明在体质成熟和生物学因素中存在可识别的共同功能基质。对于有癫痫家族史的患者以及所有可疑病例，必须考虑儿童期患有异态睡眠的受试者发生癫痫的可能性。
