Drug-Resistant Epilepsy and Obstructive Sleep Apnea: Exploring a Link Between the Two

Drug-resistant epilepsy accounts for approximately one third of all epilepsy cases; yet its exact etiopathogenesis still remains under intense exploration. Several factors have been advocated for predicting drug resistance in patients with epilepsy. Obstructive sleep apnea (OSA) is a commonly preval...

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Bibliographic Details
Published in:World neurosurgery 2021-02, Vol.146, p.210-214
Main Authors: Jaseja, Harinder, Goyal, Manish, Mishra, Priyadarshini
Format: Article
Language:English
Subjects:
Pharmacoresistant epilepsy
Refractory epilepsy
REM sleep
Sleep apnea
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Summary:Drug-resistant epilepsy accounts for approximately one third of all epilepsy cases; yet its exact etiopathogenesis still remains under intense exploration. Several factors have been advocated for predicting drug resistance in patients with epilepsy. Obstructive sleep apnea (OSA) is a commonly prevalent sleep disorder that exhibits a bidirectional and strong comorbidity with epilepsy. The exact pathophysiology of this comorbidity is not yet clearly explained. This study analyzes the relationship between drug-resistant epilepsy and OSA, and the findings indicate a strong role of rapid eye movement sleep (REMS) in the pathogenesis of this relationship. It also emerges from the study that REMS reduction is a prominent feature of OSA, and drug resistance in patients with epilepsy and treatment of OSA has been shown to restore REMS in several studies with concomitant improvement in seizure control.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2020.11.099