Devinsky O, Ehrenberg B, Barthlen G M, Abramson H S, Luciano D
Department of Neurology, New York University Medical Center, Hospital for Joint Diseases, New York.
Neurology. 1994 Nov;44(11):2060-4. doi: 10.1212/wnl.44.11.2060.
We identified seven patients with refractory partial epilepsy and sleep apnea. Treatment of the sleep apnea with nasal continuous positive airway pressure (CPAP), protriptyline, trazodone, acetazolamide, or tracheostomy reduced seizure frequency and severity in six patients. Success with CPAP depended largely on compliance. Four of five patients had a clear reduction in seizure frequency with the use of CPAP. Sleep apnea may exacerbate epilepsy by causing sleep disruption and deprivation, hypoxemia, and decreased cerebral blood flow. In epilepsy patients with risk factors (eg, obesity) or markers (eg, habitual snoring, daytime somnolence) for sleep apnea, a careful sleep history should be elicited and a polysomnogram obtained when indicated. Treatment of the sleep disorder can improve seizure control.
我们确定了7例难治性部分性癫痫合并睡眠呼吸暂停的患者。采用经鼻持续气道正压通气（CPAP）、普罗替林、曲唑酮、乙酰唑胺或气管造口术治疗睡眠呼吸暂停，使6例患者的癫痫发作频率和严重程度降低。CPAP治疗成功很大程度上取决于依从性。5例患者中有4例使用CPAP后癫痫发作频率明显降低。睡眠呼吸暂停可能通过引起睡眠中断和剥夺、低氧血症及脑血流量减少而加重癫痫。对于有睡眠呼吸暂停危险因素（如肥胖）或标志物（如习惯性打鼾、日间嗜睡）的癫痫患者，应仔细询问睡眠史，并在有指征时进行多导睡眠图检查。治疗睡眠障碍可改善癫痫控制。
