摘要
目的 癫痫患者的癫痫样放电（EDs）常常引起较差的睡眠质量.我们通过观察癫痫患者不同睡眠分期中EDs情况,探讨EDs与睡眠周期的关系.方法 240例癫痫患者与213名健康志愿者参与此项研究,所有参与者均行24 h视频脑电监测及多导睡眠图检查,检测EDs及分析睡眠结构.结果 在88.7％ （213/240）的癫痫患者中检测出EDs,但最常见于颞叶癫痫.不同睡眠分期中EDs的构成比不同,如：清醒期EDs的构成比为20.6％ （44/213）,睡眠期EDs的构成比为40.4％（86/213）,清醒及睡眠期EDs构成比为38.9％（83/213）.总睡眠时间及快速眼动期睡眠时间在癫痫患者及健康志愿者中无差异,但癫痫患者非快速眼动睡眠Ⅰ～Ⅱ期睡眠时间明显延长于健康人群[（304±39） min与（225±29） min,t=3.51,P=0.000],非快速眼动睡眠Ⅲ～Ⅳ期睡眠时间明显缩短[（49±7） min与（133±17） min,t=2.30,P=0.000],两组总睡眠时间及快速眼动睡眠时间差异无统计学意义.此外,睡眠纺锤波不对称性、高觉醒指数出现于癫痫组睡眠结构中.结论 长程视频脑电图及多导睡眠图联合应用,有助于分析EDs与睡眠周期之间的关系,有助于识别癫痫患者的睡眠障碍,进行早期的干预及治疗.
Objective The poor sleep quality of epileptic patients may be partly due to the occurrence epileptiform discharges （EDs）.We observed the number of interictal discharges in each sleep stage and explored the associations between EDs and sleep phases in epilepsy patients.Methods Two hundred and forty epileptic patients and 213 healthy volunteers were enrolled in the current study.For all subjects,video-electroencephalogram monitoring and 24 h-night polysomnography were conducted to detect EDs and analyze the sleep structures.Results EDs were detected in 88.7％ （213/240） of epilepsy patients with the most frequent cases from the temporal lobe.The EDs detected during waking,sleeping,or both waking and non-rapid eye movement （NREM） sleep stage accounted for 20.6％ （44/213）,40.4％ （86/213）,and 38.9％ （83/213） of the total patients,respectively.The total sleep time and time spent in REM were similar between the epileptic patients and healthy volunteers.However,epileptic patients spent a significantly longer mean sleep time in NREM Ⅰ-Ⅱ （（304 ±39） min versus （225 ±29） min,t =3.51,P =0.000） and less in NREM Ⅲ-Ⅳ （（49 ± 7） min versus （133 ± 17） min,t =2.30,P =0.000） than healthy volunteers.Furthermore,asymmetric sleep spindles and fragmentary sleep structure as well as high inversion frequency were found in epilepsy patients,respectively.Conclusion Combination of long-term video electroencephalogram with polysomnography is a useful method to analyze associations between EDs and the sleep-wake cycle.This strategy can also help identify the nature of sleep disorders in epileptic patients,which may improve the treatment efficacy.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2014年第1期35-38,共4页
Chinese Journal of Neurology
