Altered polysomnographic profile in juvenile myoclonic epilepsy.
OBJECTIVE
To study the spectra of sleep profile using PSG in a cohort of patients with JME attending a University hospital.


METHODS
This prospective cross-sectional case-control study involved 25 patients of JME (age: 22.0±6.3 years; M:F=13:12) on valproic acid (VPA) and 25 matched healthy controls (age: 23.2±3.04 years; M:F=16:9) were recruited. All patients underwent clinical assessment, electroencephalogram (EEG), and evaluation with sleep questionnaire and PSG.


RESULTS
PSG analysis revealed significant alterations in sleep architecture in the JME group in the form of reduced mean sleep efficiency (p=<0.035) and number of patients with reduced sleep efficiency (p=0.001), increased mean sleep onset latency (p=0.04) and number of patients with increased sleep latency (p=0.023), reduced mean N2 sleep percentage (p=0.005) and reduced mean total NREM (non-rapid eye movement) sleep (p=0.001) and increased mean wake percentage (p=0.001). The frequency of arousals, involuntary limb movements, and event related arousals in the JME groups was not different from the controls. Patients >20 years had reduced total sleep time compared to those <20 years (p=0.012). Patients with seizures for >5 years had reduced NREM sleep percentage (p=0.042) and those on VPA therapy >1 year had a longer stage 2 (p=0.03) and N3 latency (p=0.03). Patients on ≤600mg/day of VPA had a higher prevalence of isolated limb movements (p=0.01).


CONCLUSIONS
PSG revealed significant alterations in sleep architecture in JME despite adequate seizure control. There was variable degree of PSG-phenotypic correlation.
National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India. Electronic address: drpramodkrishnan@gmail.com.
Pramod
P
Krishnan
National Institute of Mental Health and Neuro Sciences, Hosur Road, Bangalore 560029, Karnataka, India. Electronic address: sanjib_sinha2004@yahoo.co.in.
Sanjib
S
Sinha
National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Electronic address: abtaly@yahoo.com.
Arun B
AB
Taly
Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Electronic address: drchaitratr@yahoo.com.
Chaitra T
CT
Ramachandraiah
National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Electronic address: shivajirao.nimhans@gmail.com.
Shivaji
S
Rao
National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Electronic address: drpsatishchandra@yahoo.com.
Parthasarathy
P
Satishchandra
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D058256:Brain Waves / Q000187:drug effects / Q000502:physiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000150:complications* / Q000188:drug therapy; D017286:Polysomnography; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000209:etiology*; D014635:Valproic Acid / Q000627:therapeutic use; D055815:Young Adult
D000927:Anticonvulsants; D014635:Valproic Acid
JME; PSG; Sleep architecture; Valproate