睡眠對癲癇及癲癇發作的影響_Journal of Epilepsy

Authors：

袁瀟 ,  孫美珍

山西醫科大學第一醫院神經內科（太原 ?030000）;

Corresponding?author：

孫美珍, Email: sunmeizhen213@126.com

Keywords：

睡眠; 癲癇; 快速動眼睡眠; 非快速動眼睡眠

DOI：

10.7507/2096-0247.20190020

Video：

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癲癇是由多種原因導致的腦部神經元高度同步化異常放電所致、以具有持久性的致癇傾向為特征的腦部疾病。越來越多的研究證實，睡眠與癲癇具有十分緊密的關系，睡眠覺醒節律對癲癇發作及發作間期癇樣放電有顯著影響。不同類型癲癇及癲癇發作有著不同的晝夜節律，額葉癲癇較顳葉癲癇更易在睡眠中發作，但顳葉癲癇更易在睡眠中繼發全面性發作。此外，不同類型癲癇發作會在特定的睡眠時相而增多，部分性發作及部分繼發全面性發作在非快速動眼期睡眠明顯增多，特別是在2期睡眠，而在快速動眼期睡眠則很少出現。非快速動眼期睡眠會促進發作間期癇樣放電的發生，相反，快速動眼期睡眠則會抑制發作間期癇樣放電的傳播，進而限制其腦區的分布范圍，從而有利于臨床中對致癇灶的定位。

Citation： 袁瀟, 孫美珍. 睡眠對癲癇及癲癇發作的影響. Journal of Epilepsy, 2019, 5(2): 113-115. doi: 10.7507/2096-0247.20190020 Copy

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2.	王兆瑞, 鄭寬, 丁季強, 等. 癲癇病灶的定位研究與進展. 實用醫學雜志, 2018, 34(6): 1036-1038.
3.	Passouant P. Historical views on sleep and epilepsy. In: Sterman MB, Shouse MN, Passouant P, eds. Sleep and epilepsy. New York: Academic Press, 1982: 1-6.
4.	Loddenkemper T, Vendrame M, Gotman J, et al. Circadian patterns of pediatric seizures. Neurology, 2011, 76: 145-153.
5.	Passouant P. Historical aspects of sleep and epilepsy. In: Degen R, Rodin EA, eds. Epilepsy, sleep, and sleep deprivation. 2nd ed. (Epilepsy Res Suppl2). Amsterdam: Elsevier scientific publishers, 1991: 19-22.
6.	Ng M, Pavlova M. Why are seizures rare in rapid eye movement sleep? review of the frequency of seizures in different sleep stages. Epilepsy Res Treat, 2013: 1-10.
7.	Bazil CW, Walczak TS. Effects of sleep and sleep stage on epileptic and nonepileptic seizures. Epilepsia, 1997, 38(1): 56-62.
8.	Crespel A, Coubes P, Baldy-Moulinier M. Sleep influence on seizuresand epilepsy effects on sleep in partial frontal and temporal lobe epilepsies. Clin Neurophysiol, 2000, 111(Suppl 2): 54-59.
9.	孫萍. 數字化長程視頻腦電圖在癲癇診斷中的應用研究. 大連: 大連醫科大學, 碩士學位論文, 2008: 1-13.
10.	劉曉燕. 臨床腦電圖學. 北京: 人民衛生出版社, 2006: 126-240.
11.	Malow BA, Lin X, Kushwaha R, et al. Interictal spiking increases with sleep depth in temporal lobe epilepsy. Epilepsia, 1998, 39(12): 1309-1316.
12.	Malow BA, Kushwahab R, Lin X, et al. Relationship of interictal epileptiform discharges to sleep depth in partial epilepsy. Electroencephalogr and Clin Neurophysiol, 1997, 102(1): 20-26.
13.	呂王丹, 初鳳娜, 孟紅梅, 等. 癲癇患者 240 發作間期癲癇樣放電與睡眠周期的關系. 中華神經科雜志, 2014, 47(1): 35-38.
14.	吳菡, 王鐘瑾, 明文杰, 等. 長程視頻腦電圖監測癲癇患者發作間期癇樣放電的時段分析. 浙江大學學報, 2017, 46(1): 30-35.
15.	Sammaritano M, Gigli GL, Gotman J. Interictal spiking during wakefulness and sleep and the localization of foci in temporal lobe epilepsy. Neurology, 1991, 41: 290-297.
16.	Ochi A, Hung R, Weiss S, et al. Lateralized interictal epileptiform discharges during rapid eye movement sleep correlate with epileptogenic hemisphere in children with intractable epilepsy secondary to tuberous sclerosis complex. Epilepsia, 2011, 52(11): 1986-1994.
17.	Minecan D, Natarajan A, Marzec M, et al. Relationship of epileptic seizures to sleep stage and sleep depth. Sleep, 2002, 25(8): 56-61.
18.	曾祥俊, 李曉泉. 癇樣放電與睡眠周期的臨床研究. 中國醫藥指南, 2017, 15(8): 137.
19.	Shouse MN, Siegel JM, Wu MF, et al. Mechanisms of seizure suppression during rapid- eye-movement (REM) sleep incats. Brain Res, 1989, 505(2): 271-282.
20.	Shouse MN, Farber PR, Staba RJ. Physiological basis: how NREM sleep components can promote and REM sleep components can suppress seizure discharge propagation. Clin Neurophysiol, 2000, 111(2): 9-18.
21.	何明穎. 無影像學改變的癲癇腦部結構變化的磁共振研究. 西安: 第四軍醫大學, 碩士學位論文, 2008: 1-19.
22.	Badawy RA, Harvey AS, Macdonell RA, et al. Cortical hyperexcitability and epileptogenesis: understanding the mechanisms of epilepsy-part 1. J Clin Neurosci, 2009, 16(3): 355-365.
23.	Frauscher B, von Ellenrieder N, Dubeau F, et al. EEG desynchronization during phasic REM sleep suppresses interictal epileptic activity in humans. Epilepsia, 2016, 57(6): 879-888.
24.	肖宇寒, 廖建湘, 黃娟, 等. 癲癇兒童發作間期癲癇樣放電特點初步研究. 中國當代兒科雜志, 2008, 10(3): 322-324.
25.	黃遠桂, 吳聲伶. 臨床腦電圖學. 西安: 陜西科學技術出版社. 1984: 116-141.
26.	周升, 劉巧英. 癲癇與睡眠的相關性研究. 中國現代醫學雜志, 2011, 21(1): 111-114.
27.	RocamoraR, Andrzejak RG, Jimenez-Conde J, et al. Sleep modulation of epileptic activity in mesial and neocortical temporal lobe epilepsy: a study with depth and subdural electrodes. Epilepsy Behav, 2013, 28(2): 185-190.
28.	趙莉. 癲癇與睡眠關系的腦電圖分析. 山西醫藥雜志, 2013, 42(11): 1223-1224.
29.	Yu YL, Yan YL, Tian SF, et al. Circadian rhythm of interictal epileptiform discharges and changes of spindles in patients with temporal lobe epilepsy. Biomedi Res, 2018, 29(6): 1263-1267.
30.	Nobili L, Baglietto GM, Beelke EM, et al. Spindles-inducing mechanism modulates sleep activation of interictal epileptiform discharges in the Landua-Kleffner syndrome. Epilepsia, 2000, 41(1): 201-206.
31.	Drake ME Jr, PakalniA, Padamadan H, et al. Sleep spindles in epilepsy. Clin Electroencephalogr, 1991, 22(3): 144-149.
32.	Busek P, Buskova J, Nevsimalova S, et al. Interictal epileptiform discharges and phasic phenomena of REM sleep. Epileptic Disord, 2010, 12(3): 217-221.

1. 中華醫學會. 臨床診療指南—癲癇病分冊. 北京: 人民衛生出版社, 2007: 35-36.
2. 王兆瑞, 鄭寬, 丁季強, 等. 癲癇病灶的定位研究與進展. 實用醫學雜志, 2018, 34(6): 1036-1038.
3. Passouant P. Historical views on sleep and epilepsy. In: Sterman MB, Shouse MN, Passouant P, eds. Sleep and epilepsy. New York: Academic Press, 1982: 1-6.
4. Loddenkemper T, Vendrame M, Gotman J, et al. Circadian patterns of pediatric seizures. Neurology, 2011, 76: 145-153.
5. Passouant P. Historical aspects of sleep and epilepsy. In: Degen R, Rodin EA, eds. Epilepsy, sleep, and sleep deprivation. 2nd ed. (Epilepsy Res Suppl2). Amsterdam: Elsevier scientific publishers, 1991: 19-22.
6. Ng M, Pavlova M. Why are seizures rare in rapid eye movement sleep? review of the frequency of seizures in different sleep stages. Epilepsy Res Treat, 2013: 1-10.
7. Bazil CW, Walczak TS. Effects of sleep and sleep stage on epileptic and nonepileptic seizures. Epilepsia, 1997, 38(1): 56-62.
8. Crespel A, Coubes P, Baldy-Moulinier M. Sleep influence on seizuresand epilepsy effects on sleep in partial frontal and temporal lobe epilepsies. Clin Neurophysiol, 2000, 111(Suppl 2): 54-59.
9. 孫萍. 數字化長程視頻腦電圖在癲癇診斷中的應用研究. 大連: 大連醫科大學, 碩士學位論文, 2008: 1-13.
10. 劉曉燕. 臨床腦電圖學. 北京: 人民衛生出版社, 2006: 126-240.
11. Malow BA, Lin X, Kushwaha R, et al. Interictal spiking increases with sleep depth in temporal lobe epilepsy. Epilepsia, 1998, 39(12): 1309-1316.
12. Malow BA, Kushwahab R, Lin X, et al. Relationship of interictal epileptiform discharges to sleep depth in partial epilepsy. Electroencephalogr and Clin Neurophysiol, 1997, 102(1): 20-26.
13. 呂王丹, 初鳳娜, 孟紅梅, 等. 癲癇患者 240 發作間期癲癇樣放電與睡眠周期的關系. 中華神經科雜志, 2014, 47(1): 35-38.
14. 吳菡, 王鐘瑾, 明文杰, 等. 長程視頻腦電圖監測癲癇患者發作間期癇樣放電的時段分析. 浙江大學學報, 2017, 46(1): 30-35.
15. Sammaritano M, Gigli GL, Gotman J. Interictal spiking during wakefulness and sleep and the localization of foci in temporal lobe epilepsy. Neurology, 1991, 41: 290-297.
16. Ochi A, Hung R, Weiss S, et al. Lateralized interictal epileptiform discharges during rapid eye movement sleep correlate with epileptogenic hemisphere in children with intractable epilepsy secondary to tuberous sclerosis complex. Epilepsia, 2011, 52(11): 1986-1994.
17. Minecan D, Natarajan A, Marzec M, et al. Relationship of epileptic seizures to sleep stage and sleep depth. Sleep, 2002, 25(8): 56-61.
18. 曾祥俊, 李曉泉. 癇樣放電與睡眠周期的臨床研究. 中國醫藥指南, 2017, 15(8): 137.
19. Shouse MN, Siegel JM, Wu MF, et al. Mechanisms of seizure suppression during rapid- eye-movement (REM) sleep incats. Brain Res, 1989, 505(2): 271-282.
20. Shouse MN, Farber PR, Staba RJ. Physiological basis: how NREM sleep components can promote and REM sleep components can suppress seizure discharge propagation. Clin Neurophysiol, 2000, 111(2): 9-18.
21. 何明穎. 無影像學改變的癲癇腦部結構變化的磁共振研究. 西安: 第四軍醫大學, 碩士學位論文, 2008: 1-19.
22. Badawy RA, Harvey AS, Macdonell RA, et al. Cortical hyperexcitability and epileptogenesis: understanding the mechanisms of epilepsy-part 1. J Clin Neurosci, 2009, 16(3): 355-365.
23. Frauscher B, von Ellenrieder N, Dubeau F, et al. EEG desynchronization during phasic REM sleep suppresses interictal epileptic activity in humans. Epilepsia, 2016, 57(6): 879-888.
24. 肖宇寒, 廖建湘, 黃娟, 等. 癲癇兒童發作間期癲癇樣放電特點初步研究. 中國當代兒科雜志, 2008, 10(3): 322-324.
25. 黃遠桂, 吳聲伶. 臨床腦電圖學. 西安: 陜西科學技術出版社. 1984: 116-141.
26. 周升, 劉巧英. 癲癇與睡眠的相關性研究. 中國現代醫學雜志, 2011, 21(1): 111-114.
27. RocamoraR, Andrzejak RG, Jimenez-Conde J, et al. Sleep modulation of epileptic activity in mesial and neocortical temporal lobe epilepsy: a study with depth and subdural electrodes. Epilepsy Behav, 2013, 28(2): 185-190.
28. 趙莉. 癲癇與睡眠關系的腦電圖分析. 山西醫藥雜志, 2013, 42(11): 1223-1224.
29. Yu YL, Yan YL, Tian SF, et al. Circadian rhythm of interictal epileptiform discharges and changes of spindles in patients with temporal lobe epilepsy. Biomedi Res, 2018, 29(6): 1263-1267.
30. Nobili L, Baglietto GM, Beelke EM, et al. Spindles-inducing mechanism modulates sleep activation of interictal epileptiform discharges in the Landua-Kleffner syndrome. Epilepsia, 2000, 41(1): 201-206.
31. Drake ME Jr, PakalniA, Padamadan H, et al. Sleep spindles in epilepsy. Clin Electroencephalogr, 1991, 22(3): 144-149.
32. Busek P, Buskova J, Nevsimalova S, et al. Interictal epileptiform discharges and phasic phenomena of REM sleep. Epileptic Disord, 2010, 12(3): 217-221.

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