Review Article: Sleep, Epilepsy, and the EEG in Infancy and Childhood

Abstract

Each of the major epileptic syndromes that occur in infants and children demonstrates relationships to sleep and wakefulness that are particular to that syndrome. These relationships include activation or suppression of clinical seizures during certain portions of the sleep-wake cycle, differences in symptomatology of the seizures or in seizure type, alterations in distribution or morphology of epileptiform waveforms, and changes in duration and composition of sleep stages. Knowledge of the interactions between sleep and seizures helps to increase understanding of the physiological mechanisms underlying epilepsy, as well as to improve clinical diagnosis.

Pediatric sleep and epilepsy

“…The spike and slow wave pattern of the Lennox-Gaustaut Syndrome (LGS) becomes more active, appearing more frequent and occurring in prolonged trains lasting several minutes during NREM sleep. The opposite occurs during REM sleep [40]. The ESES syndrome is characterized by the presence of almost continuous spike and wave discharges during NREM sleep.…”

A Pilot Study to Assess a Teaching Intervention to Improve Sleep–Wake Disturbances in Parents of Children Diagnosed With Epilepsy

“…A review of sleep, epilepsy, and electroencephalographic (EEG) findings in infancy and childhood (Donat & Wright, 1989) concluded that the transition from the sleep to wake or wake These data may help us understand why children with poor sleep quality may not report significant daytime sleepiness. to sleep state is the most common period for a lowered seizure threshold in most of the major epileptic syndromes in infants and children, and more recent studies have also reinforced that wakefulness and sleep are more important predictors of seizure timing than day or night (Kaleyias et al, 2011;Loddenkemper et al, 2011;Loddenkemper, Wyllie, & Hirsch, 2012;Zarowski et al, 2011).…”

Yield of Outpatient Sleep EEG for Epileptiform Alterations' Detection in Children

“…The yield of the first EEG study to identify interictal epileptiform abnormalities (IEA) after a first unprovoked seizure in children ranges from 32% to 59% in adults (Baldin et al, 2014). Sleep may activate IEA in approximately a third of patients with epilepsy and up to 90% of those with epilepsies related to sleep or awakening (Donat & Wright, 1989;Vaughn & D'Cruz, 2004). In this context, sleep deprivation is frequently used to increase the EEG sensitivity (Pratt et al, 1968).…”