Effect of treatment of obstructive sleep apnea on seizure outcomes in children with epilepsy.
A retrospective review of children with epilepsy and obstructive sleep apnea, treated surgically for their obstructive sleep apnea from January 2008-October 2010, was performed for age, sex, type of epilepsy, antiseizure medications, sleep-study data, and changes in seizure frequency. Twenty-seven subjects (median age, 5 years) with no adjustment to their medications around their time of surgery were identified. Three months after surgery, 10 (37%) patients became seizure-free, three (11%) demonstrated >50% seizure-reduction, and six (22%) exhibited an amelioration of seizure frequency. Two (7%) demonstrated unchanged seizure-frequency, and six (22%) manifested a worsening of seizure frequency. Median seizure frequency before surgery was 8.5 (interquartile range, 2-90), and after surgery, three (interquartile range, 0-75), with a 53% median seizure reduction. Multivariate analysis demonstrated a trend toward seizure freedom with each percentile increase in body mass index and early age of surgery. We conclude that obstructive sleep apnea surgery may decrease seizure frequency, especially in children with elevated body mass index scores and younger age at time of surgery.
Department of Neurology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA.
Eric
E
Segal
Martina
M
Vendrame
Matthew
M
Gregas
Tobias
T
Loddenkemper
Sanjeev V
SV
Kothare
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D020181:Sleep Apnea, Obstructive / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome
D000927:Anticonvulsants