Sleep-related hypermotor epilepsy: A prediction cohort study on sleep/awake patterns of seizures.
driver's license
evolution patterns
nocturnal frontal lobe epilepsy
sleep-related hypermotor epilepsy
sleep/wakefulness distribution
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
23
07
2019
revised:
14
09
2019
accepted:
17
09
2019
pubmed:
16
10
2019
medline:
16
4
2020
entrez:
16
10
2019
Statut:
ppublish
Résumé
Sleep-related hypermotor epilepsy (SHE) is characterized by hyperkinetic seizures arising from sleep. Awake seizures occasionally occur and are associated with a worse prognosis, with important implications for driving and quality of life. We evaluated the clinical features and sleep/wakefulness distribution of seizures at onset and lifelong in a large cohort of clinical/confirmed SHE. Chi-square test and a multivariate logistic regression model were used to identify predictors of awake seizures lifelong (primary endpoint). Positive and negative likelihood ratio (LR+, LR-) were calculated. We included 165 patients (male/female: 105/60) with a 27.6-year median follow-up. Most (67.9%) presented with seizures exclusively from sleep; 32.1% presented with seizures both while asleep and while awake, or exclusively during wakefulness. Presentation with seizures in wakefulness shows a sensitivity of 62.5% and a specificity of 96.5% to predict the occurrence of awake seizures lifelong, with an LR + of 18 (95% confidence interval [CI] = 5.75-55) and LR- of 0.39 (95% CI = 0.29-0.52). On multivariate analysis, distribution of sleep/awake seizures at onset was confirmed as an independent risk factor of awake seizures lifelong (odds ratio = 56.7). Patients presenting with awake seizures have a 94% probability of awake seizures lifelong, whereas in those presenting with asleep seizures only, the percentage lowers to 27%. This aspect should be mentioned during physician-to-patient communication about prognosis.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e115-e120Subventions
Organisme : Fondazione Telethon
ID : GGP 13200
Pays : International
Informations de copyright
Wiley Periodicals, Inc. © 2019 International League Against Epilepsy.
Références
Tinuper P, Bisulli F, Cross JH, et al. Definition and diagnostic criteria of sleep-related hypermotor epilepsy. Neurology. 2016;86:1834-42.
Scheffer IE, Bhatia KP, Lopes-Cendes I, et al. Autosomal dominant frontal epilepsy misdiagnosed as sleep disorder. Lancet. 1994;343:515-7.
Picard F, Baulac S, Kahane P, et al. Dominant partial epilepsies. A clinical, electrophysiological and genetic study of 19 European families. Brain. 2000;123(6):1247-62.
Ferri L, Bisulli F, Nobili L, et al. Auditory aura in nocturnal frontal lobe epilepsy: a red flag to suspect an extra-frontal epileptogenic zone. Sleep Med. 2014;15:1417-23.
Oldani A, Zucconi M, Asselta R, et al. Autosomal dominant nocturnal frontal lobe epilepsy. A video-polysomnographic and genetic appraisal of 40 patients and delineation of the epileptic syndrome. Brain. 1998;121:205-23.
Licchetta L, Bisulli F, Vignatelli L, et al. Sleep-related hypermotor epilepsy: long-term outcome in a large cohort. Neurology. 2017;88:70-7.
Nobili L, Francione S, Mai R, et al. Surgical treatment of drug-resistant nocturnal frontal lobe epilepsy. Brain. 2007;130:561-73.
Derry CP. The sleep manifestations of frontal lobe epilepsy. Curr Neurol Neurosci Rep. 2011;11:218-26.
Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58:522-30.
Gilliam F, Kuzniecky R, Faught E, Black L, Carpenter G, Schrodt R. Patient-validated content of epilepsy-specific quality-of-life measurement. Epilepsia. 1997;38:233-6.
Josephson CB, Patten SB, Bulloch A, et al. The impact of seizures on epilepsy outcomes: a national, community-based survey. Epilepsia. 2017;58:764-71.
Hoppe C, Poepel A, Elger CE. Epilepsy: accuracy of patient seizure counts. Arch Neurol. 2007;64:1595-9.