Role of continuous positive airway pressure therapy on the pathogenesis of sleep-related frontal lobe epilepsy in a child with obstructive sleep apnea syndrome.
We describe an obese child with severe obstructive sleep apnea syndrome in whom nocturnal frontal lobe seizures developed within a week after therapy was started with continuous positive airway pressure. The video polysomnographic study after the onset of nocturnal episodes showed 3 seizures: 2 starting from slow-wave sleep when he was sleeping with continuous positive airway pressure, and 1 from stage 2 non-rapid eye movement sleep when he was sleeping without continuous positive airway pressure. Cyclic alternating pattern analysis during the video polysomnography recorded after the onset of nocturnal seizures disclosed a high cyclic alternating pattern rate during slow-wave sleep, and the recording obtained after antiepileptic therapy began showed a low cyclic pattern analysis rate. In this child, we describe the non-rapid eye movement sleep instability induced by continuous positive airway pressure therapy might have had a role in triggering the nocturnal seizures.
Miano
Silvia
S
Department of Pediatrics, Sleep Centre, University of Rome La Sapienza, S. Andrea Hospital, Rome, Italy.
Pelliccia
Andrea
A
Evangelisti
Melania
M
Pagani
Jacopo
J
Villa
Maria Pia
MP
D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects*; D004569:Electroencephalography; D004827:Epilepsy / Q000209:etiology* / Q000503:physiopathology*; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications; D010507:Periodicity; D017286:Polysomnography; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012893:Sleep Wake Disorders / Q000150:complications / Q000503:physiopathology; D012895:Sleep, REM / Q000502:physiology