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. (J Child Neurol 1989;4:84-94).
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References
1.
Sterman MB, Shouse MN , Passouant P (eds): Sleep and Epilepsy. New York, Academic Press, 1982.
2.
Martins da Silva A, Binnie CD, Meinardi H (eds): Biorhythms and Epilepsy. New York, Raven Press, 1985.
3.
Hogan T., Sundaram M.: Abnormal EEG patterns and the effect of sleep: A review. Am J EEG Technol1988; 28:99-112.
4.
Mizrahi EM, Kellaway P.: Characterization and classification of neonatal seizures. Neurology1987;37:1837-1844.
5.
Legido A., Clancy RR, Berman PH, et al: Recent advances in the diagnosis, treatment, and prognosis of neonatal seizures. Pediatr Neurol1988;4:79-86.
6.
Clancy RR, Legido A., Lewis D., et al: Occult neonatal seizures. Epilepsia1988;29:256-261.
7.
Lacy JR, Penry JK: Infantile Spasms. New York, Raven Press, 1976, pp 79-105.
8.
Singer WD, Rabe EF, Haller JS: The effect of ACTH treatment upon infantile spasms. J Pediatr1980;96:485-489.
9.
Kellaway P., Hrachovy RA, Frost JD Jr, et al: Precise characterization and quantification of infantile spasms . Ann Neurol1979;6:214-218.
Hrachovy RA , Frost JD Jr, Kellaway P.: Hypsarrhythmia: Variations on the theme. Epilepsia1984:25:317-325.
12.
Hrachovy RA , Frost JD Jr, Kellaway P.: Sleep characteristics in infantile spasms . Neurology1981;31:688-694.
13.
Fukuyama Y. , Shionaga A., Iida Y.: Polygraphic study during whole night sleep in infantile spasms. Eur Neurol1979;18: 302-311.
14.
Gastaut H., Roger J., Soulayrol R., et al: Childhood epileptic encephalopathy with diffuse slow spike-waves (otherwise known as "petit mal variant") or Lennox syndrome. Epilepsia1966;7:139-179.
Papini M., Pasquinelli A., Armellini M., et al: Alertness and incidence of seizures in patients with Lennox-Gastaut syndrome. Epilepsia1984;25:161-167.
17.
Aicardi J.: Epilepsy in Children. The International Review of ChildNeurology , New York, Raven Press , 1986, pp 39-65.
18.
Markand ON: Slow spike-wave activity in EEG and associated features: Often called 'Lennox' or 'Lennox-Gastaut' syndrome. Neurology1977 ;27: 746-757.
19.
Erba G., Moschen R., Ferber R.: Sleep-related changes in EEG discharge activity and seizure risk in patients with Lennox-Gastaut syndrome. Sleep Res1981 ;10:247.
20.
Erba G., Browne TR: Atypical absence, myoclonic, atonic, and tonic seizures and the "Lennox-Gastaut syndrome," in Browne TR, Feldman RG (eds): Epilepsy, Diagnosis and Management. Boston, Little Brown , 1983, pp 75-94.
21.
Karbowski K. , Vassella F., Schneider H.: Electroencephalographic aspects of Lennox syndrome. Eur Neurol1970 ;4: 301-309.
22.
Erba G., Cavazzuti V.: Tonic seizures with arousal: Report of a case. Sleep Res1981;10:245.
23.
Rodin E., Smid N., Mason K.: The grand mal pattern of Gibbs, Gibbs, and Lennox. Electroencephalogr Clin Neurophysiol1976; 40:401-406.
24.
Amir N., Shalev RS, Steinberg A.: Sleep patterns in the Lennox-Gastaut syndrome. Neurology1986;36:1224-1226.
25.
Erba G., Cavazzuti V.: Ictal and interictal response latency in Lennox-Gastaut syndrome. Electroencephalogr Clin Neurophysiol1977;42:717.
26.
Aarts JHP , Binnie CD, Smit AM, et al: Selective cognitive impairment during focal and generalized epileptiform EEG activity. Brain1984;107: 293-308.
27.
Goode DJ, Penry JK, Dreifuss FE: Effects of paroxysmal spike-wave on continuous visual motor performance . Epilepsia1970;11:241-254.
28.
Porter RJ, Penry JK, Dreifuss FE: Responsiveness at the onset of spike-wave bursts. Electroencephalogr Clin Neurophysiol1973;34:239-245.
29.
Patry G., Lyagoubi S., Tassinari C.: Subclinical "electrical status epilepticus" induced by sleep in children . Arch Neurol1971;24: 242-252.
30.
Tassinari CA , Bureau M., Dravet C., et al: Electrical status epilepticus during sleep in children (ESES) , in Sterman MB, Shouse MN, Passouant P (eds): Sleep and Epilepsy. New York , Academic Press, 1982, pp 465-479.
31.
Kellerman K. : Recurrent aphasia with subclinical bioelectric status epilepticus during sleep. Eur J Pediatr1978;128:207-212.
32.
Gascon G., Victor D., Lombroso CT, et al: Language disorder, convulsive disorder, and electroencephalographic abnormalities. Arch Neurol1973; 28:156-162.
33.
Schoumaker MRD , Bennet DR, Bray PF, et al: Clinical and EEG manifestations of an unusual aphasic syndrome in children. Neurology1974; 24:10-16.
34.
Rodriguez I. , Niedermeyer E.: The aphasia epilepsy syndrome in children: Electroencephalographic aspects. Clin Electroencephalogr1982;13: 23-35.
35.
Penry JK, Porter RJ, Dreifuss FE: Simultaneous recording of absence seizures with video tape and electroencephalography . Brain1975;98:427-440.
36.
Sato S.: Generalized seizures: Absence, in Dreifuss FE (ed): Pediatric Epileptology. Classification and Management of Seizures in the Child. Boston, John Wright-PSG Inc, 1983, pp 65-91.
37.
Burr W., Stefan H., Penin H.: Epileptic activity during sleep and wakefulness. Eur Neurol1986; 25(Suppl 2):141-145.
38.
Niedermeyer E. : Petit mal, primary generalized epilepsy and sleep, in Sterman MB, Shouse MN, Passouant P (eds): Sleep and Epilepsy. New York , Academic Press, 1982, pp 191-207.
39.
Halasz P., Devenyi E.: Petit mal absences in night sleep with special reference to transitional sleep and REM periods. Acta Med Sci Hung1974 ;31: 107-112.
40.
Sato S., Dreifuss FE, Penry JK: The effect of sleep on spike-wave discharges in absence seizures. Neurology1973;23: 1335-1345.
41.
Declerck AC: Interaction sleep and epilepsy. Eur Neurol1986;25(Suppl 2):117-127.
42.
Gloor P.: Generalized corticoreticular epilepsies: Some considerations on the pathophysiology of generalized bilaterally synchronous spike and wave discharge . Epilepsia1968;9: 249-263.
43.
Niedermeyer E. : Sleep electroencephalograms in petit mal . Arch Neurol1965;12:625-630.
44.
Niedermeyer E.: Generalized seizure discharges and possible precipitating mechanisms. Epilepsia1966;7:23-29.
45.
Niedermeyer E.: Common generalized epilepsy: The so-called idiopathic or centrencephalic epilepsy. Eur Neurol1973;9: 133-156.
46.
Halasz P.: The generalized epileptic spike-wave mechanism and the sleep-wakefulness system . Acta Physiol Hung1972;42: 293-314.
47.
Kellaway P. , Frost JD Jr, Crawley JW: Time modulation of spike-and-wave activity in generalized epilepsy. Ann Neurol1980;8:491-500.
48.
Kellaway P., Frost JD: Biorhythmic modulation of epileptic events, in Pedley TA, Meldrum BS (eds): Recent Advances in Epilepsy . London, Churchill-Livingstone , 1983, pp 139-154.
49.
Stevens JR: Sleep is for seizures: A new interpretation of the role of phasic ocular events in sleep and wakefulness, in Sterman MB, Shouse MN, Passouant P (eds): Sleep and Epilepsy. New York , Academic Press, 1982, pp 249-264.
50.
Jeavons PM: Nosological problems of myoclonic epilepsies in childhood and adolescence . Dev Med Child Neurol1977;19:3-8.
51.
Tassinari C. , Terzano G., Capocchi G., et al: Epileptic seizures during sleep in children, in Penry JK (ed): Epilepsy, The Eighth International Symposium. New York , Raven Press , 1977, pp 345-354.
52.
Asconape J. , Penry JK: Some clinical and EEG aspects of benign juvenile myoclonic epilepsy. Epilepsia1984;25:108-114.
53.
Delgado-Escueta AV, Enrile-Bacsal F.: Juvenile myoclonic epilepsy of Janz. Neurology1984;34:285-294.
54.
Janz D.: The natural history of primary generalized epilepsies with sporadic myoclonias of the "impulsive petit mal" type, in Lugaresi P, Pazzaglia P, Tassinari CA (eds): Evolution and Prognosis of Epilepsies . Bologna, Aulo Gaggi , 1973, pp 55-61.
55.
Niedermeyer E.: The generalized multiple spike wave discharge. An electroclinical study. Electroencephalogr Clin Neurophysiol1966;20:133-138.
56.
Janz D.: The grand mal epilepsies and the sleeping-waking cycle. Epilepsia1962;3:69-109.
57.
Cavazzuti GB : Epidemiology of different types of epilepsy in school age children in Modena, Italy. Epilepsia1980;21:57-62.
58.
Heijbel J., Blom S., Bergfors PG: Benign epilepsy of children with centrotemporal EEG foci. A study of incidence rate in outpatient care. Epilepsia1975;16:657-664.
59.
Loiseau P., Beaussart M.: The seizures of benign childhood epilepsy with Rolandic paroxysmal discharges . Epilepsia1973;14:381-389.
60.
Lombroso C. : Sylvian seizures and midtemporal spike foci in children. Arch Neurol1967;17:52-59.
61.
Dalla Bernardina B., Calamaria V., Caporilla G., et al: Nocturnal sleep and benign Rolandic epilepsy, in Degen R, Niedermeyer E (eds): Epilepsy, Sleep and Sleep Deprivation. Amsterdam, Elsevier , 1984, pp 119-133.
62.
Beaussart M. : Benign epilepsy of children with Rolandic (centro-temporal) paroxysmal foci: A clinical entity. Study of 221 cases. Epilepsia1972;13:795-811.
63.
Dalla Bernardina B., Tassinari CA: EEG of a nocturnal seizure in a patient with "benign epilepsy of childhood with Rolandic spikes."Epilepsia1975;16:497-501.
64.
Gregory DL, Wong PK: Topographical analysis of the centrotemporal discharges in benign Rolandic epilepsy of childhood. Epilepsia1984;25:705-711.
65.
Blom S., Heijbel J.: Benign epilepsy of children with centrotemporal EEG foci: Discharge rates during sleep. Epilepsia1975;16:133-140.
66.
Lerman P., Kitivy S.: Benign focal epilepsy of childhood: A follow-up study of 100 recovered patients . Arch Neurol1975;32: 261-264.
67.
Clemens B., Olah R.: Sleep studies in benign epilepsy of childhood with Rolandic spikes. II. Analysis of discharge frequency and its relation to sleep dynamics. Epilepsia1987;28:24-27.
68.
Beaumanoir A., Ballis T., Varfis G., et al: Benign epilepsy of childhood with Rolandic spikes. Epilepsia1974;15:301-315.
69.
Gastaut H.: A new type of epilepsy: Benign partial epilepsy of childhood with occipital spike-waves, in Akimoto H, Kazamatsuri H, Seino M, et al (eds): Advances in Epileptology: XIIIth Epilepsy International Symposium. New York, Raven Press, 1982, pp 19-24.
70.
Beaumanoir A.: Infantile epilepsy with occipital focus and good prognosis. Eur Neurol1983;22:43-52.
71.
Newton R., Aicardi J.: Clinical findings in children with occipital spike-wave complexes suppressed by eye-opening. Neurology1983;33:1526-1529.
72.
Deonna T., Ziegler A-L., Despland P-A., et al: Partial epilepsy in neurologically normal children: Clinical syndromes and prognosis. Epilepsia1986;27:241-247.
73.
Holmes GL: Partial seizures in children. Pediatrics1986 ;77: 725-731.
74.
Dahl M., Dam M.: Sleep and epilepsy. Ann Clin Res1985 ;17: 235-242.
75.
Rossi GP, Colicchio G., Pola P.: Interictal epileptic activity during sleep: A stereo-EEG study in patients with partial epilepsy. Electroencephalogr Clin Neurophysiol1984;58:97-106.
76.
Billiard M.: Epilepsies and the sleep-wake cycle, in Sterman MB, Shouse MN, Passouant P (eds): Sleep and Epilepsy. New York, Academic Press, 1982, pp 269-285.
77.
Gabor AJ, Seyal M.: Effect of sleep on the electrographic manifestations of epilepsy. J Clin Neurophysiol1986;3:23-38.
78.
Hess R., Urech S., Wieser HG: Arousal patterns in depth recording from epileptics, in Sterman MB, Shouse MN , Passouant P (eds): Sleep and Epilepsy. New York, Academic Press, 1982, pp 209-217.
79.
Pratt KL, Mattson RH, Weikers NJ, et al: EEG activation of epileptics following sleep deprivation: A prospective study of 114 cases. Electroencephalogr Clin Neurophysiol1968;24:11-15.
80.
Lee SI: Electroencephalography in infantile and childhood epilepsy, in Dreifuss FE (ed): Pediatric Epileptology. Classification and Management of Seizures in the Child. Boston, John Wright-PSG Inc, 1983 , pp 33-63.
81.
Holmes GL: Partial complex seizures in children: An analysis of 69 seizures in 24 patients using EEG FM radiotelemetry and videotape recording. Electroencephalogr Clin Neurophysiol1984; 57:13-20.
82.
Duchowny MS : Complex partial seizures in infancy. Arch Neurol1987;44:911-914.
83.
Ellingson RJ , Wilken K., Bennett DR: Efficacy of sleep deprivation as an activation procedure in epilepsy patients . J Clin Neurophysiol1984;1:83-101.
84.
Guilleminault C., Baker TL: Sleep and electroencephalography: Points of interest and points of controversy. J Clin Neurophysiol1984;1:275-291.
85.
Okawa M., Sasaki H.: Sleep disorders in mentally retarded and brain-impaired children, in Guilleminault C (ed): Sleep and Its Disorders in Children. New York, Raven Press, 1987, pp 269-289.
86.
Shibagaki M. , Kiyono S., Watanabe K.: Nocturnal sleep in severely mentally retarded children: Abnormal EEG patterns in sleep cycle. Electroencephalogr Clin Neurophysiol1980;49: 337-344.
87.
Binnie CD: Are biological rhythms of importance in epilepsy? in Martins da Silva A, Binnie CD, Meinardi H (eds): Biorhythms and Epilepsy . New York, Raven Press, 1985, pp 1-11.
88.
Martins da Silva A., Aarts JHP, Binnie CD, et al: The circadian distribution of interictal epileptiform EEG activity. Electroencephalogr Clin Neurophysiol1984;58:1-13.
89.
Bridgers SL , Ebersole JS: Supervision of ambulatory cassette EEG screening: A strategy based on the temporal distribution of epileptiform abnormalities . Electroencephalogr Clin Neurophysiol1987 ;66:219-224.
90.
Rosen I., Blennow G., Risberg AM, et al: Quantitative evaluation of nocturnal sleep in epileptic children , in Sterman MB, Shouse MN, Passouant P (eds): Sleep and Epilepsy. New York, Academic Press, 1982, pp 397-409.
Shouse MN: Sleep, sleep disorders, and epilepsy in children, in Guilleminault C (ed): Sleep and Its Disorders in Children . New York, Raven Press , 1987, pp 291-307.
93.
Peled R., Lavie P.: Paroxysmal awakenings from sleep associated with excessive daytime somnolence: A form of nocturnal epilepsy. Neurology1986 ;36:95-98.
94.
Clemens B., Olah R.: Sleep studies in benign epilepsy of childhood with Rolandic spikes . I. Sleep pathology. Epilepsia1987; 28:20-23.
95.
Roder-Wanner U-U., Noachtar S., Wolf P.: Response of polygraphic sleep to phenytoin treatment for epilepsy. A longitudinal study of immediate, short- and long-term effects. Acta Neurol Scand1987;76:157-167.
96.
Johnson LC: Effects of anticonvulsant medication on sleep patterns, in Sterman MB, Shouse MN , Passouant P (eds): Sleep and Epilepsy. New York, Academic Press, 1982, pp 381-394.
97.
Wolf P., Roder-Wanner U-U., Brede M., et al: Influences of antiepileptic drugs on sleep, in Martins da Silva A, Binnie CD, Meinardi H (eds): Biorhythms and Epilepsy . New York, Raven Press, 1985, pp 137-153.
98.
Knight DR, Le Portz MT, Harper JR: Natural sleep as an aid to electroencephalographic diagnosis in young children . Electroencephalogr Clin Neurophysiol1977 ;43:312-316.
99.
Tartara A., Manni R.: Diagnostic value of spontaneous afternoon sleep in epilepsy: Polysomnographic study of 96 epileptic patients. Eur Neurol1986;25:26-31.
100.
Scollo-Lavizzari G., Pralle W., Radue E.: Comparative study of efficacy of waking and sleep recordings following sleep deprivation as an activation method in the diagnosis of epilepsy. Eur Neurol1977;15:121-123.
101.
Degen R., Degen H.-E, Reker M.: Sleep EEG with or without sleep deprivation? Does sleep deprivation activate more epileptic activity in patients suffering from different types of epilepsy ? Eur Neurol1987;26:51-59.
102.
Greer M., Andriola MR: Convulsive disorders of childhood, in Thompson RA, Green JR (eds): Pediatric Neurology and Neurosurgery. New York , SP Medical & Scientific Books, 1978, pp 241-281.
103.
Rowan AJ, Veldhuisen RJ, Nagelkerke NJ: Comparative evaluation of sleep deprivation and sedated sleep EEGs as diagnostic aids in epilepsy. Electroencephalogr Clin Neurophysiol1982;54:357-364.
104.
Degen R.: A study of the diagnostic value of waking and sleep EEGs after sleep deprivation in epileptic patients on anticonvulsant therapy. Electroencephalogr Clin Neurophysiol1980; 49:577-584.
105.
Tartara A. , Moglia A., Manni R., et al: EEG findings and sleep deprivation . Eur Neurol1980;19:330-334.
106.
Declerck AC, Sijben-Kiggen R., Waquier A., et al: Diagnosis of epilepsy with the aid of sleep methodology: Evaluation of 1163 cases, in Sterman MB, Shouse MN, Passouant P (eds): Sleep and Epilepsy. New York , Academic Press, 1982, pp 453-460.
107.
Aicardi J. : Epilepsy in Children. The International Review of ChildNeurology, New York, Raven Press, 1986, pp 287-308.
Coleman RM , Pollak CP, Weitaman ED: Periodic movements in sleep (nocturnal myoclonus): Relation to sleep disorders. Ann Neurol1980 ;8:416-421.
110.
Parkes JD, Baraitser M., Marsden CD, et al: Natural history, symptoms and treatment of the narcoleptic syndrome . Acta Neurol Scand1975;52:337-353.
111.
Lugaresi E., Cirignotta F.: Nocturnal paroxysmal dystonia, in Sterman MB, Shouse MN, Passouant P (eds): Sleep and Epilepsy. New York, Academic Press, 1982, pp 507-511.
112.
Mano T., Shiozawa Z., Sobue I.: Extrapyramidal involuntary movements during sleep, in Broughton RJ (ed): Henri Gastaut and the Marseilles School's contribution to the neurosciences. Electroencephalogr Clin Neurophysiol1982;35(Suppl):431-442.
113.
Seshia SS, Reggin JD, Stanwick RS: Migraine and complex seizures in children. Epilepsia1985;26:232-236.
114.
Guilleminault C., Silvestri R.: Disorders of arousal and epilepsy during sleep, in Sterman MB, Shouse MN, Passouant P (eds): Sleep and Epilepsy. New York , Academic Press, 1982, pp 513-531.
115.
Pedley TA: Differential diagnosis of episodic symptoms. Epilepsia1983;24(Suppl 1):S31-S34.
116.
Guilleminault C.: Disorders of arousal in children: Somnambulism and night terrors, in Guilleminault C (ed): Sleep and Its Disorders in Children. New York , Raven Press, 1987, pp 243-252.
117.
Tassinari CA, Mancia D., Dalla Bernardina B., et al: Pavor nocturnus of nonepileptic nature in epileptic children. Electroencephalogr Clin Neurophysiol1972;33:603-607.
118.
Lerman P., Kitivy S.: Focal epileptic EEG discharges in children not suffering from clinical epilepsy . Epilepsia1981;22:551-558.
119.
Goldensohn ES , Koehle R.: EEG Interpretation: Problems of Overreading and Underreading. New York, Futura Publishing Company, 1975, pp 30-31.
120.
Erwin CW, Somerville ER, Radtke RA: A review of electroencephalographic features of normal sleep. J Clin Neurophysiol1984;1:253-274.
121.
Klass DW, Westmoreland BF: Nonepileptogenic epileptiform electroencephalographic activity. Ann Neurol1985;18:627-635.
