Tobacco habits in nocturnal frontal lobe epilepsy

Naldi, Ilaria; Bisulli, Francesca; Vignatelli, Luca; Licchetta, Laura; Pittau, Francesca; Vito, Lidia Di; Mostacci, Barbara; Menghi, Veronica; Provini, Federica; Montagna, Pasquale; Tinuper, Paolo

doi:10.1016/j.yebeh.2012.10.014

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…However, despite the reported positive effect of nicotine in reducing seizure frequency, a case–control family study, did not find a higher tendency to smoke tobacco in SHE patients and their relatives compared with the control cases. 110 …”

Section: Management Strategiesmentioning

confidence: 99%

Sleep-related hypermotor epilepsy: prevalence, impact and management strategies

Menghi

Bisulli

Tinuper

et al. 2018

NSS

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Sleep-related hypermotor epilepsy (SHE), previously called nocturnal frontal lobe epilepsy (NFLE), is a focal epilepsy characterized by asymmetric tonic/dystonic posturing and/or complex hyperkinetic seizures occurring mostly during sleep. SHE fulfills the definition of rare disease with an estimated minimum prevalence of 1.8/100,000 individuals, and it represents about 10% of drug-resistant surgical cases. Although SHE and autosomal-dominant SHE (ADSHE) have been considered benign epileptic conditions for a long time, emerging data have shed light on the severity of this disorder and some peculiar features can impact negatively on the quality of life of SHE patients. In fact, seizure frequency can be very high, resulting in nocturnal sleep fragmentation with possible diurnal consequences such as excessive sleepiness and fatigue. Moreover, recent studies, adopting a systematic neuropsychological assessment, have shown deficits in memory, executive functions and visuo-spatial abilities in almost half of SHE patients. Intellectual disabilities and psychiatric disorders have also been reported in some genetic forms. SHE may also exert a negative effect on health-related quality of life, especially in domains pertaining to a patient’s role in the family, social context and patient’s illness experience.Despite a good response to pharmacological treatment, especially with carbamazepine, 30% of SHE patients suffer from drug-resistant seizures. Finally, recent studies suggest a poor prognosis in a high percentage of SHE patients with a 20.4% cumulative probability of achieving terminal remission at 10 years from onset. For selected drug-resistant SHE patients, epilepsy surgery is the only treatment offering high probability of recovery, both for seizures and for epilepsy-related sleep alterations.

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Section: Management Strategiesmentioning

confidence: 99%

Sleep-related hypermotor epilepsy: prevalence, impact and management strategies

Menghi

Bisulli

Tinuper

et al. 2018

NSS

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“…However, in sporadic nocturnal frontal lobe epilepsy failed to determine the role of smoking 24 . Another study showed that nicotine patch use in video EEG monitoring increased the hospitalization of people with epilepsy as fewer seizure events were captured 25 .…”

Section: Introductionmentioning

confidence: 99%

Smoking prevalence and seizure control in Chinese males with epilepsy

Gao

Sander

et al. 2017

Epilepsy & Behavior

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Smoking has a negative effect on most diseases, yet it is under-investigated in people with epilepsy; thus its role is not clear in the general population with epilepsy. We performed a retrospective pilot study on males with epilepsy to determine the smoking rate and its relationship with seizure control using univariate analysis to calculate odds ratios (ORs) and also used a multi-variate logistic regression model. The smoking rate in our sample of 278 individuals was 25.5%, which is lower than the general Chinese population smoking rate among males of 52.1%. We used two classifications: the first classified epilepsy as generalized, or by presumed topographic origin (temporal, frontal, parietal and occipital). The second classified the dominant seizure type of an individual as generalized tonic clonic seizure (GTCS), myoclonic seizure (MS), complex partial seizure (CPS), simple partial seizure (SPS), and secondary GTCS (sGTCS). The univariable analysis of satisfactory seizure control profile and smoking rate in both classifications showed a trend towards a beneficial effect of smoking although most were not statistically significant. Considering medication is an important confounding factor that would largely influence seizure control, we also conducted multi-variable analysis for both classifications with drug numbers and dosage. The result of our model also suggested that smoking is a protective factor. Our findings seem to suggest that smoking could have a potential role in seizure control although confounders need exploration particularly in view of the potential long term health effects. Replication in a much larger sample is needed as well as case control studies to elucidate this issue.

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“…Considering the role of the cholinergic system in arousal regulatory processes, these observations suggested a possible link between nicotine defect, alteration of arousal regulation and seizures in SHE/ADSHE patients. However, despite the reported positive effect of nicotine in reducing seizure frequency, a case-control family study, did not find a higher tendency to smoke tobacco in SHE patients and their relatives compared to the control cases (Naldi et al 2013).…”

Section: Ach Receptor Genesmentioning

confidence: 88%

Sleep related hyper motor epilepsy (SHE): a unique syndrome with heterogeneous genetic etiologies

Bisulli

Licchetta

Tinuper

2019

Sleep Science Practice

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Sleep-related hypermotor epilepsy (SHE), formerly known as Nocturnal Frontal Lobe Epilepsy is a focal epilepsy characterized by seizures with complex hyperkinetic automatisms and/or asymmetric tonic/dystonic posturing occurring mostly during sleep. SHE is a rare disease with an estimated minimum prevalence of 1.8/100,000 individuals and represent about 10% of drug-resistant surgical cases. This disorder, though uncommon, is of considerable interest to a broad spectrum of specialists, from child neurologists to neurosurgeons. Distinguishing this condition from nonepileptic paroxysmal behaviour occurring physiologically or pathologically during sleep is often difficult and sometimes impossible on clinical grounds alone, even for experienced epileptologists and sleep physicians. Recognized aetiologies of SHE are heterogeneous and include acquired injuries, genetic causes and structural anomalies such as focal cortical dysplasia. Multiple aetiologies (structural-genetic) are also possible. Non-specific clinical features distinguished different aetiologies even if SHE due to structural lesions usually manifests with early-onset drug-resistant seizures and showed a worse long-term prognosis. The causative genes for SHE are multiple and encode for proteins involved in different molecular pathways. The cholinergic system and the mTOR pathway are the most relevant. This review will provide an exhaustive overview of the genetic background of SHE.

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Tobacco habits in nocturnal frontal lobe epilepsy

Cited by 10 publications

References 29 publications

Sleep-related hypermotor epilepsy: prevalence, impact and management strategies

Sleep-related hypermotor epilepsy: prevalence, impact and management strategies

Smoking prevalence and seizure control in Chinese males with epilepsy

Sleep related hyper motor epilepsy (SHE): a unique syndrome with heterogeneous genetic etiologies

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