EEG recording after sleep deprivation in a series of patients with juvenile myoclonic epilepsy

Seizures in Juvenile Myoclonic Epilepsy (JME) are dependent on the sleep-wake cycle and precipitant factors, among which sleep deprivation (SD) is one of the most important. Still an under diagnosed syndrome, misinterpretation of the EEGs contributes to diagnostic delay. Despite this, a quantitative...

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Published in:Arquivos de neuro-psiquiatria 2005-06, Vol.63 (2B), p.383-388
Main Authors: Sousa, Nise Alessandra de Carvalho, Sousa, Patrícia da Silva, Garzon, Eliana, Sakamoto, Américo C, Braga, Nádia I O, Yacubian, Elza Márcia Targas
Format: Article
Language:English
Subjects:
Adolescent
Adult
Electroencephalography
Humans
Middle Aged
Myoclonic Epilepsy, Juvenile - diagnosis
Myoclonic Epilepsy, Juvenile - physiopathology
NEUROSCIENCES
PSYCHIATRY
Sleep Deprivation - physiopathology
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Summary:Seizures in Juvenile Myoclonic Epilepsy (JME) are dependent on the sleep-wake cycle and precipitant factors, among which sleep deprivation (SD) is one of the most important. Still an under diagnosed syndrome, misinterpretation of the EEGs contributes to diagnostic delay. Despite this, a quantitative EEG investigation of SD effects has not been performed. We investigated the effect of SD on EEGs in 41 patients, aged 16-50 yr. (mean 25.4), who had not yet had syndromic diagnosis after a mean delay of 8.2 yr. Two EEG recordings separated by a 48-hour interval were taken at 7 a.m. preceded by a period of 6 hours of sleep (routine EEG) and after SD (sleep-deprived EEG). The same protocol was followed and included a rest wakefulness recording, photic stimulation, hyperventilation and a post-hyperventilation period. The EEGs were analyzed as to the effect of SD on the number, duration, morphology, localization and predominance of abnormalities in the different stages. A discharge index (DI) was calculated. Out of the 41 patients, 4 presented both normal EEG recordings. In 37 (90.2%) there were epileptiform discharges (ED). The number of patients with ED ascended from 26 (70.3%) in the routine EEG to 32 (86.5%) in the sleep-deprived exam. The presence of generalized spike-wave and multispike-wave increased from 20 (54.1%) and 13 (35.1%) in the first EEG to 29 (78.4%) and 19 (51.4%) in the second, respectively (p
ISSN:0004-282X
1678-4227
0004-282X
DOI:10.1590/S0004-282X2005000300003