An Increase in Seizure Severity Maybe Related to a Decrease in REM Sleep in Children with Hypothalamic Hamartomas.
Abstract number :
1.097
Submission category :
Year :
2001
Submission ID :
280
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
T.J. Dunn, M.D., EEG/Sleep, NIH/NINDS, Bethesda, MD; S. Sato, M.D., EEG/Sleep, NIH/NINDS, Bethesda, MD; K. Liow, M.D., Neurology, Kansas University, Wichita, KS; L. Biesecker, M.D., NHGRI, NIH, Bethesda, MD; W. Theodore, M.D., Epilpesy, NIH/NINDS, Bethesd
RATIONALE: To determine if alterations in REM sleep in children with hypothalamic hamartoma(HH) correlates with an increase in seizure severity
METHODS: Six children (3-13 years of age) with HH and gelastic seizures underwent one or two nights of polysomnographic recordings. During a 23 channel polysomnogram, we monitored EEG, EOG, EKG, respiration and leg movements. No changes in medication were made prior to the recording. Sleep stages were scored according to Rechtschaffen and Kales method (1968). An index for epilepsy severity was calculated by multiplying epilepsy duration in years by mean number of seizures/day. We used student T-test, Wilcoxon ranked sum test and linear regression for statistical analysis.
RESULTS: The averages of sleep stages in the 6 children are: stage 1 10%, stage 2 51.5%, stage 3 33.9%, stage 4 17.2%, and REM 4.1%. Compared with normative data, REM sleep occupies 25%-30% of sleep while non-rem(NREM) sleep occupies the remaining 70%-75%. There was a significant reduction in REM sleep. The seizure severity index ranged from 14 to 71.6 with a mean of 31.5. No significant correlation could be made between a decrease in REM sleep and seizure severity(p=0.122). There was, however, a strong trend showing a decreased percentage of REM sleep was associated with an increased severity of seizures
CONCLUSIONS: The hypothalamus is known to control some aspects of sleep mechanisms. Our study shows the patients with HH and gelastic seizures do have decreased amounts of REM sleep, which is most likely a result of the HH. This decreased amount of REM sleep seems to be associated with increased seizure severity, namely more seizures. Further studies with larger sample sizes of children with HH may help elucidate this trend.
Support: National Institutes of Health/ National Institutes of Neurolgical Diseases and Stroke