A Study of the diagnostic value of waking and sleep EEGs after sleep deprivation in epileptic patients on anticonvulsive therapy

Degen, R

doi:10.1016/0013-4694(80)90398-3

Cited by 75 publications

(37 citation statements)

References 14 publications

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“…In our previous studies we likewise recorded most epileptic discharges in stage C of those patients with various seizure types [Degen, 1977[Degen, , 1980a as well as in those with specific types [De gen, 1980b;Dcgen andDegen, 1981, 1983a, b, in prep.]. Other authors also found most specific activity in the light to medium sleep stages [Bechinger et al, 1973;Delange et al, 1962;White et al, 1962], That generalized spike-wave complexes as.…”

Section: Discussionmentioning

confidence: 78%

“…High activation rates of epileptic activity in sleep without sleep deprivation Degen, 1981, 1983a;Christian, 1961;Ganshirt and Vetter, 1961;Gibbs and Gibbs, 1947;Jovanovic, 1967] as well as with sleep deprivation [Bechinger et al, 1973;Bechinger and Kornhuber, 1976;Degen, 1977Degen, , 1980aDegen, 1981, 1983a;Gastaut et al, 1984;Kubicki et al, 1984;Matt son et al, 1965;Pratt et al, 1968;Ritter et al, 1977;Scollo-Lavizzari et al, 1975, 1977Wittenberger and Kubicki, 1977] are re ported in the literature. As sleep deprivation is very troublesome both for the patients and the staff, we questioned whether in fact sleep after sleep deprivation gives a higher activa tion rate than normal sleep.…”

Section: Discussionmentioning

confidence: 99%

“…These, as given in the literature, range between 34 [Geller et al, 1969] and 74% [Bechinger and Kornhuber, 1976], We recorded epileptic ac tivity amongst patients whose waking EEGs showed no specific discharges and who were under antiepileptic therapy, in sleep after sleep deprivation of 24 h in 58 and 51 % [Degen, 1977[Degen, , 1980a, As sleep deprivation is troublesome for the patient as well as for the staff we questioned whether in fact a higher rate of activation can be achieved by a sleep EEG after sleep depri vation than by a simple sleep EEG.…”

Section: Introductionmentioning

confidence: 99%

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Sleep EEG with or without Sleep Deprivation?

Degen¹,

Degen²,

Reker³

1987

Eur Neurol

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A sleep EEG of 190 patients without sleep deprivation was recorded, followed by a sleep EEG after 24 h of sleep deprivation on the next day. The patients suffered from various types of epilepsy, in their routine EEGs no epileptic discharges were seen. Both sleep EEGs were recorded under the same antiepileptic drugs. A waking EEG was recorded immediately before each sleep EEG. The activation rates of epileptic activity in 52.6% (without sleep deprivation) and 53.2% (with sleep deprivation) of the patients showed no significant differences. Also on classifying the epileptic discharges no real difference was found between the 2 methods (generalized: 29.5 vs. 29.5%, generalized with lateral emphasis: 11.1 vs. 9.5%, focal: 12.1 vs. 14.2%). Only in the waking EEG, recorded immediately before the sleep EEG after sleep deprivation, a few more patients showed epileptic discharges (33.6 vs. 27.4%). Without there being any significant differences between the 2 methods there were some different results in comparing the EEG with the clinical findings: significantly more epileptic activity was shown in patients who had their first seizure before the age of 20 (55.6 and 55.6 % vs. 26.3 and 31.6%), amongst females (59.8 and 61.9% vs. 45.2 and 44.1%), in awakening grand mal (= primary generalized tonic-clonic seizures, 76.5 and 70%) and in absences (69 and 72.4%). The higher activation rates in young subjects, in patients with a family history of seizures, with pathological neurological findings, mental retardation and delayed psychomotoric development in early childhood, were not statistically significant. As sleep deprivation is troublesome both for the patients and the staff, and as the same rate of patients show epileptic discharges in sleep without and with sleep deprivation, this method is dispensable for clinical practice.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sleep EEG with or without Sleep Deprivation?

Degen¹,

Degen²,

Reker³

1987

Eur Neurol

Self Cite

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“…20,22 So it seems prudent to obtain a sleep deprived awake EEG followed by sleep, in children with clinical impression of seizure activity, or paroxysmal behavior for which seizure disorder is to be ruled out. This obviates the need to perform a second EEG in those whose routine EEG has been normal, and the suspicion of clinical seizure is still high.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Sleep-Deprived Eeg in the Diagnosis of Seizure Disorders in Children

Rafiei¹

2006

Neuropediatrics

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The provocative effects of sleep deprivation (SD) on patients with seizure disorder and on the electroencephalogram (EEG) are well known.The purpose of the study was to test its routine use and usefulness in the pediatric and adolescent age group with, or suspect of having, seizure disorder, especially those presenting with first unprovoked seizure.Between September 2000 and November 2002, among patients referring to the author's clinic and the Pediatric Emergency Department of Nemazi Hospital, Shiraz, 598 children and adolescents were randomly assigned to a 10-minute surface EEG, either routinely, or after a period of partial or total SD. Those who refused or could not tolerate the SD procedure entered the routine group. The EEG's were analyzed for the presence of epileptic abnormality.Of 598 patients, 544( 91%) had clinical seizures; the rest (54, 9%) were seizure suspects or had seizure "mimickers" (syncope, night terrors, pseudo-seizures, etc). Of seizure patients, 210 ( 38.6 % ) suffered from a first unprovoked seizure, and the rest (334, 61.4%) had more than one seizure episode at the time of EEG performance.Abnormal epileptiform EEG's were more frequently seen in the group of seizure patients who were sleep-deprived before performing the EEG, as compared to the routine group. Conversely, more normal EEG's were seen upon routine performance of EEG ( p value <00001, χ 2 = 76.5). Similarly, more abnormal sleep-deprived EEG's were seen in patients with first unprovoked seizure than when EEG was done routinely in this subgroup of patients. Patients with complex partial seizure had significantly more abnormal EEG's when subjected to SD (p<00001).Older patients could tolerate SD better than the younger age group; so more routine EEG's had to be performed in the younger age group.Younger children could only tolerate partial SD. There was no difference in the yield of EEG in patients with absence epilepsy between the two groups. In 5 patients with juvenile myoclonic epilepsy, SD precipitated a generalized tonic-clonic seizure which necessitated acute antiepileptic drug administration to the seizure activity.All patients with non-seizure episodes showed normal EEG's. In conclusion SD can be safely applied in the work-up of selected pediatric patients with seizure disorder, especially in those with their first unprovoked seizure, in whom an abnormal EEG might dictate anti-epileptic drug therapy.Not all children with seizure disorder need to undergo SD for EEG, as it may not Medical

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“…Sleep disturbances tend to parallel the severity of epileptic disorders. It is well known that seizures and the underlying neuropathologies can disrupt sleep (Shouse et al 1996) and sleep deprivation can also precipitate focal and generalized epileptiform activity (Degan 1980, Fountain et al 1998. Furthermore, certain types of seizures are known to occur more frequently during sleep -for example, partial seizures, such as benign rolandic epilepsy, frontal-lobe epilepsy, and tonic seizures in Lennox-Gastaut syndrome.…”

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confidence: 99%

Melatonin treatment of non‐epileptic myoclonus in children

Jan¹,

Connolly

Hamilton

et al. 1999

Develop Med Child Neuro

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Oral melatonin (MLT) has been used by our Vancouver research group in the treatment of paediatric sleep disorders since 1991; slightly over 200 children, mainly with multiple disabilities, who frequently had seizures, have been treated. Three children with markedly delayed sleep onset due to recurring myoclonus were also referred for MLT treatment: two had non‐epileptic, and one had epileptic and non‐epileptic myoclonus. Low doses of oral MLT (3 to 5 mg) unexpectedly abolished their myoclonus and allowed them to sleep. There were no adverse effects. It appears that certain types of myoclonus, which might be resistant to conventional anticonvulsant medications, may respond to MLT but the mechanism of action is unclear. Further research on this novel treatment is urgently needed.

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A Study of the diagnostic value of waking and sleep EEGs after sleep deprivation in epileptic patients on anticonvulsive therapy

Cited by 75 publications

References 14 publications

Sleep EEG with or without Sleep Deprivation?

Sleep EEG with or without Sleep Deprivation?

Usefulness of Sleep-Deprived Eeg in the Diagnosis of Seizure Disorders in Children

Melatonin treatment of non‐epileptic myoclonus in children

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