Palomino A, Carballo M, Rodríguez E, Arenas C, Acilona V, Ortega E, Boza F
Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España.
Rev Neurol. 1998 Nov;27(159):801-4.
The initial phases and transitional periods of sleep facilitate electroclinical manifestations of juvenile myoclonic epilepsy (JME). The period at the time of waking is identified in the different phases of sleep by cyclic electrophysiological oscillations, which in turn are synchronous with the spike-and-wave or multiple spike-and-wave activity of the electric crises seen in JME and other epileptic syndromes. This observation supports the theory of an alternating cyclical pattern (ACP) as the trigger of these discharges.
Following classical macrostructural and microstructural patterns of EEG sleep analysis, we investigated electrophysiological behavior in 13 patients diagnosed as having JME, and 5 persons of homogeneous epidemiological characteristics as controls.
In our study we observed that both groups had similar macrostructural sleep parameters. However, in patients prone to crises, these were concentrated in the first two hours recorded and showed no differences in sleep-waking transition or ACP of phase I sleep. These were significant when both periods were compared with the remaining NREM sleep.
We conclude from this study that ACP is the microstructural element of sleep which modulates and permits classification of epileptiform anomalies, mainly in studies at the time of wakening.
睡眠的初始阶段和过渡期有助于青少年肌阵挛性癫痫(JME)的电临床表型。通过周期性电生理振荡在睡眠的不同阶段识别觉醒时的时期,而这些振荡又与JME和其他癫痫综合征中出现的癫痫发作时的棘波 - 慢波或多棘波 - 慢波活动同步。这一观察结果支持交替循环模式(ACP)理论是这些放电的触发因素。
按照脑电图睡眠分析的经典宏观结构和微观结构模式,我们调查了13例诊断为JME的患者以及5名具有相同流行病学特征的对照者的电生理行为。
在我们的研究中,我们观察到两组具有相似的宏观结构睡眠参数。然而,在易发作的患者中,这些发作集中在记录的前两小时,并且在睡眠 - 觉醒转换或第一阶段睡眠的ACP方面没有差异。当将这两个时期与其余非快速眼动睡眠进行比较时,这些差异具有统计学意义。
我们从这项研究中得出结论,ACP是睡眠的微观结构要素,它调节并允许对癫痫样异常进行分类,主要是在觉醒时的研究中。