| 수면성 간질의 임상양상수면성 간질의 임상양상 |
| 박선아, 박수철, 김원주, 이세진, 이준홍, 이병인 |
| 연세대학교 의대 신경과, 영남대학교 의대 신경과 |
| Clinical characteristics of nocturnal epilepsy |
| Sun Ah Park, M.D., Soo Chul Park, M.D., Won Joo Kim, M.D., Se Jin Lee, M.D., Joon Hong Lee, M.D., Byung In Lee, M.D. |
| Department of Neurology, college of Medicine, Yonsei University, Department of Neurology, College of Medicine, Yongnam University |
|
|
|
|
| Abstract |
Background and Objectives: Nocturnal epilepsy is rare but an interesting phenomenon suggesting a close relationship between epilepsy and sleep. However, previous efforts to characterize the nocturnal epilepsy as a specific epileptic syndrome have been incomplete. This study was conducted to evaluate the prognosis and the recurrence rate of diurnal seizure in patients presented with nocturnal seizures only to further determine the clinical characteristics of nocturnal epilepsy.
Methods: Sixty-six patients with nocturnal seizures only were identified through the epilepsy registry form of the Yonsei Epilepsy Clinic(YEC) Data Bank. All patients had thorough history, physical and neurological examinations, blood tests, sleep deprived EEG with nasopharyngeal electrodes, and MRI or CT of brain according to the protocol of YEC. Patients followed at the YEC shorter than one year were excluded from the data analysis. All patients included to the study were initially treated by maximally tolerable monotherapy and then polytherapy if seizures were not controlled.
Results: Among sixty-six, patients, seizure descriptions were compatible with generalized tonic-clonic seizures in forty-seven patients and partial seizures with or without GTC in ninteen patients. EEG demonstrated either generalized or partial interictal epileptiform discharges in twenty-nine patients. CT or MRI showed focal lesions in eleven patients. For the follow up period of average thirty-nine months, twenty-five patients developed seizures while awake. Comparison of clinical characteristics between the patients with nocturnal seizures only and the patients with recurrent diurnal seizures did reveal followings ; duration of seizures at the time of initial evaluation was longer in the diurnal seizure (6. 7 vs. 9. 3 years), but it was not statistically significant (p<0.05). The presence of partial features in the history, neurological examinations, EEG, and MRI were more frequently associated with recurrent diurnal seizures. Responses to the AEDs |
|
PDF Links
Full text via DOI
Download Citation
