Sleep Talking

About 10 of children engage in sleep talking on a regular basis, and in one series of sleep laboratory studies of adults, sleep talking occurred during 13 of recorded nights (Rechtschaffen et al., 1962). Sleep talking occurs during sleep or during brief arousals and generally consists of just a few words with minimal emotional content some patients, however, may speak a few sentences and occasionally speech consists of loud or angry comments. Speech during REM...

Mark S Scher

Department of Pediatrics Pediatric Neurology Pediatric Epilepsy and Sleep Programs Rainbow Babies and Children's Hospital University Hospitals of Cleveland Case Western Reserve University Cleveland, Ohio Unique Aspects of the Ultradian Sleep Rhythm of the Fetus and Neonate Epileptic Syndromes during Neonatal Infancy Periods Benign Familial Neonatal (Infantile) Convulsions Benign Epilepsies of Infancy Early Infantile Epileptic Encephalopathy Infantile Spasms or West Syndrome Severe Epileptic...

Multiple Sleep Latency Test

The multiple sleep latency test (MSLT) is performed following nocturnal polysomnography, a standardized test, which consists of five naps lasting 20 min each, performed at 2-h intervals. The presence of short sleep latencies (i.e., mean < 8 min), and sleep onset rapid eye movement (REM) (i.e., within 15 min of sleep onset) during at least two naps of the MSLT also confirm the diagnosis of narcolepsy, in association with a history of episodes of cataplexy. The muscle atonia seen in cataplexy...

Nocturnal Paroxysmal Motor Phenomena

Diurnal Paroxysmal Dyskinesias Responsive to Anticonvulsants Hypnogenic Paroxysmal Dystonia or Epilepsy Other Sleep-Related Paroxysmal Events Nocturnal Frontal Lobe Epilepsy Autosomal Dominant Frontal Lobe Epilepsy Summary References nocturnal paroxysmal motor phenomena The nature of paroxysmal motor phenomena occurring during sleep has been a matter of debate for many years. Various sleep disorders associated with motor activity such as sleepwalking (somnambulism), sleep talking, night terrors...

Info

The reasons for patients with extratemporal lobe epilepsy being less prone to postictal sleep may be due to the fact that those seizures are of shorter duration or may be linked to the spread pattern of the seizures and to which specific neuronal population is involved with the ictus. The etiologies for the patients with focal epilepsies were diverse (Table 17.3) (Nair et al., 1999). Two out of six patients with generalized epilepsy reported sleeping after a dialepic seizure. Both of these...

Cyclic Alternating Pattern And Noncyclic Alternating Pattern

CAP is organized in sequences of two or more CAP cycles. Each CAP cycle consists of a phase A and a phase B, each lasting between 2 and 60 s. All CAP sequences begin with a phase A and end with a phase B. In NREM sleep, the phase A patterns are composed of the single or clustered arousal-related phasic events peculiar to the single sleep stages Intermittent alpha rhythms and sequences of vertex sharp waves, in stage 1 Sequences of two or more K-complexes with or without alphalike components and...

Cyclic Alternating Pattern Rate

CAP time is the temporal sum of all CAP sequences. CAP time can be calculated throughout total NREM sleep and within the single NREM stages. The percentage ratio of CAP time to sleep time is referred to as CAP rate. CAP rate can be measured in NREM sleep (percentage ratio of total CAP time to total NREM sleep time) and in the single NREM stages (percentage ratio of CAP time in a given stage to the total duration of that stage throughout sleep). In human sleep, CAP rate is an index of arousal...

Nocturnal Dissociative Disorder

In dissociative disorder, the major symptom is a disruption of consciousness, identity, memory, or perception that has a psychogenic basis. If the disturbance affects consciousness primarily, awareness is dissociated from behavior and patients engage in complex behaviors for which they are amnestic. Identity is primarily affected in depersonalization disorder and multiple personality disorder (American Psychiatric Association, 1994). While prolonged nocturnal fugues occur in some patients,...

Rapid Eye Movement Behavior Disorder

RBD is characterized by the emergence of prominent motor activity from sleep, associated with dream content (Schenck and Mahowald, 1990). The motor activity is often violent including punching, kicking, or running from bed with resultant injury to the patient or bed partner. The individual usually is acting out his or her dreams or nightmares. The PSG may demonstrate the presence of augmented electromyographic (EMG) tone during REM sleep. The motor phenomena such as kicking or punching...

T8p8

It has been estimated that simply repeating the EEG at another point in time may increase the yield by 20 (Salinsky et al, 1987 Pratt, 1968 Fountain etal., 1998). Studies comparing sleep deprived EEG with drug-induced sleep EEGs have reported conflicting findings, some finding greater activation of ED with drug-induced sleep (Degen and Degen, 1981, 1983, 1991 Veldhuisen, 1983 Degen et al, 1987). Others (Sherwin and Hooge, 1973 Rumpl et al, 1977 Rowan et al, 1982...

Clinical Features Of Rapid Eye Movement Sleep Behavior Disorder

Although various PSG and clinical features of RBD have been identified by investigators from three continents since 1966 (Mahowald and Schenck, 1994), RBD was not formally recognized and named until 1986-1987 (Schenck et al., 1986 Schenck et al., 1987). RBD was incorporated within the international classification of sleep disorders (ICSD) in 1990. A typical clinical presentation of RBD is as follows (Schenck et al., 1986) A 67-year-old dextral man was referred because of violent behavior during...

F3c3 C3p3

FIGURE 6.2 EEG from scalp and sphenoidal electrodes during wakefulness, sleep stage 3 and REM sleep for this same patient with a temporal lobe focus. Spl and Sp2 are the left and right sphenoidal electrodes. Note similarity of spiking fields in wakefulness and REM sleep and bilateral independent temporal spiking in stage 3. There is maximal focalization of spiking during REM sleep. (From Sammaritano, M., et al., Interictal spiking during wakefulness and sleep and the localization of foci in...

Mario Giovanni Terzano

Sleep Disorders Center Department of Neurology University of Parma Italy Epilepsy and Vigilance States Sleep Propensity and Body Temperature Rhythms Sleep Intensity and Slow-Wave Sleep Nonrapid Eye Movement Rapid Eye Movement Sleep Cycle Dynamics of Thalamic Neurons during Sleep Low-Frequency (< 1 Hz) Oscillations in the Human Sleep Electroencephalogram Cyclic Alternating Pattern as a Marker of Sleep Instability Scoring of Cyclic Alternating Pattern Parameters Cyclic Alternating Pattern and...

Other Sleeprelated Paroxysmal Events

Other sleep-related paroxysmal events were identified as epileptic as well. Peled and Lavie (1986) described 14 patients with hypersomnia secondary to recurrent nocturnal arousals, which were shown to be associated with paroxysmal epileptiform discharges occurring exclusively during stage 2 or 3 of NREM sleep three patients showed dramatic improvement after treatment with anticonvulsants. Montagna et al. (1990) made similar observations, concluding that, even though epileptic in nature,...

Effect Of Epilepsy

To investigate the effect of the epilepsy on sleep architecture, patients have been studied with polysomnography on nights when they are not having seizures. Patients with primary generalized epilepsy and patients with focal epilepsy were evaluated in terms of total sleep time, proportion of NREM and REM sleep, wakefulness, number of awakenings gt 2 min, and awakenings lt 2 min. An increase in the WASO, awakenings lt 2 min and gt 2 min were found Touchon, 1991 . In this study, the patients were...

Parasomnia Overlap Disorder

Our center has reported on a group of 33 RBD patients with PSG-docu-mented overlapping NREM-REM sleep motor parasomnias consisting of sleepwalking, sleep terrors, and RBD Schenck et al., 1997b . Mean age was 34 14 years mean age of parasomnia onset was 15 16 years range 1-66 70 n 23 were males. An idiopathic subgroup n 22 had a significantly earlier mean age of parasomnia onset 9 7 years than a symptomatic subgroup n 11 27 23 years whose parasomnia began with neurological disorders, n 6...

Association Of Rapid Eye Movement Sleep Behavior Disorder With Specific Human Leukocyte Antigen Haplotypes

Narcolepsy, like RBD, is a prominent disorder of REM sleep dysregulation. Narcolepsy has a very strong association with HLA class II genes, with the DQB 1 0602 DQwl group allele being expressed in nearly all cases. Our center performed HLA class II antigen phenotyping in a group of 25 Caucasian males who had RBD but not narcolepsy 84 n 21 were DQwl DQB 1 05,06 positive and 28 n 7 were DR2 positive DQB 1 0501 n 9 and DQB 1 0602 n 7 were the most common phenotypes Schenck et al., 1996b . The 84...

Video Electroencephalography Polysomnography Technical Aspects

Epilepsy and Sleep Physiological and Clinical Relationships Copyright 2001 by Academic Press. All rights of reproduction in any form reserved. Electrocardiography Respiration Case Examples Case No. 1 Case No. 2 Case No. 3 Summary References The relationship between epilepsy and sleep was recognized in antiquity by both Hippocrates and Aristotle. The systematic study of the occurrence of seizure in relation to the sleep-wake cycle has been reported since the end of the nineteenth century Gowers,...

Focal Epilepsy and Sleep

Sleep Seizure Division New England Medical Center Tufts University Boston, Massachusetts Video Electroencephalography Polysomnography Modification of Sleep Architecture in Epilepsy Effects of Antiepileptic Drugs on Sleep Many authors have chosen to describe sleep-epilepsy interactions as reciprocal relationships between the effects of sleep on epilepsy and the effects of epilepsy on sleep Montplaisir et al., 1985 Sammaritano et. al., 1991 . To understand these interactions between sleep and...

Longterm Evolution And Prognosis

The long-term evolution of this syndrome has been described in detail by Morikawa et al. 1985, 1992, 1995 , Bureau et al. 1990 , Tassinri et al. 1992b . The data may be split into those concerning the EEG features, the epilepsy, and the neuropsychological impairment. ESES is a self-limited EEG finding and disappears in all cases. Normalization is progressive and is completed within 3 years. In the Marseille series Bureau et al., 1990 Tassinari et al, 1992b , the average age of apparent end of...

Primary Sleep Disorders In Patients With Epilepsy

The incidence of primary sleep disorders in the epileptic population is unknown. The literature contains mostly retrospective studies in which patients with epilepsy and suspected sleep disorders are included. Consequently, the reported incidence of sleep disorders is likely to be overestimated. Prospective studies are required to determine how these figures compare with those of the general population. In the largest retrospective study, 63 adults with epilepsy were referred for PSG for EDS...

Generalized Epilepsy and Sleep

Department of Neurology University of Munich Munich, Germany Relations of Epileptic Seizures to Sleep-Wake Cycle Sleep Pattern of Patients with Generalized Epilepsy Relation of Epileptiform Discharges to the Sleep-Wake Cycle and Sleep Stages in Generalized Epilepsy Sleep Deprivation Effects of Antiepileptic Drugs on Sleep There are several relationships between generalized epilepsy and sleep, both clinically and electroencephalographically. It has been known since the days of Aristotle...