title: The cooccurrence of interictal discharges and seizures in pediatric sleep-disordered breathing.
abstract: Studies in the literature data have shown that the prevalence of obstructive sleep apnea (OSA) in children with epilepsy is high and that treatment for OSA leads to a reduction in the number of seizures; by contrast, few studies have demonstrated an increased prevalence of interictal epileptiform discharges (IEDs) or epilepsy in children with sleep-disordered breathing (SDB). The aim of the present study was to confirm the high prevalence of IEDs or epilepsy in a large sample of children with SDB and to collect follow-up data. Children were recruited prospectively and underwent their first video-polysomnography (video-PSG) for SDB in a teaching hospital sleep center. Of the 298 children who fulfilled the diagnostic criteria for sleep-disordered breathing, 48 (16.1%) children were found to have IEDs, three of these 48 children were also found to have nocturnal seizures (two females diagnosed with rolandic epilepsy and a male diagnosed with frontal lobe epilepsy). Only 11 subjects underwent a second video-PSG after 6months; at the second video-PSG, the IEDs had disappeared in six subjects, who also displayed a reduced AHI and an increased mean overnight saturation. Thirty-eight of the 250 children without IEDs underwent a second video-PSG after 6months. Of these 250 children, four, who did not display any improvement in the respiratory parameters and were found to experience numerous stereotyped movements during sleep, were diagnosed with nocturnal frontal lobe epilepsy. Our study confirms the high prevalence of IEDs in children with SDB. Follow-up data indicate that they may recede over time, accompanied by an improvement of sleep respiratory parameters.
authors.affiliation: Neuroscience, Mental Health and Sense Organs Department, Chair of Pediatrics, Sleep Disorder Centre, "La Sapienza" University, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Miano
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tabarrini
authors.forename: Ottavio
authors.initials: O
authors.lastname: Vitelli
authors.forename: Annamaria
authors.initials: A
authors.lastname: Mazzotta
authors.forename: Marco
authors.initials: M
authors.lastname: Del Pozzo
authors.forename: Jole
authors.initials: J
authors.lastname: Rabasco
authors.forename: Mario
authors.initials: M
authors.lastname: Barreto
authors.forename: Pasquale
authors.initials: P
authors.lastname: Parisi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ferretti
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Villa
mesh_terms: D000886:Anthropometry; D058256:Brain Waves / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017286:Polysomnography; D012640:Seizures / Q000150:complications*; D012891:Sleep Apnea Syndromes / Q000150:complications*
keywords: AHI; BECTS; BMI; Children; Epilepsy; Epileptiform discharges; IEDs; OSA; Obstructive sleep apnea; PSG; SaO(2); Seizure; apnea–hypopnea index; benign epilepsy with centrotemporal spikes; body mass index; interictal epileptiform discharges; mean overnight oxygen saturation; obstructive sleep apnea; polysomnography