title: [The importance of sleep deprivation as a mechanism for activating interictal epileptiform paroxysms].
abstract: BACKGROUND
  Although sleep deprivation has been used for years in electroencephalography (EEG) as a method for activating interictal epileptiform discharges (IED) in patients with a strong suspicion of epilepsy, its sensitivity and specificity are still under discussion.
  
  
  METHODS
  We conducted a descriptive retrospective study of paediatric patients who were referred to a neurophysiology clinic for epilepsy assessment. The results of the sleep-deprived EEG (SD-EEG) were compared with those of the wakefulness EEG (W-EEG) carried out in each patient in order to describe the performance of each method as a mechanism for activating IED.
  
  
  RESULTS
  A total of 500 patients were analysed (830 SD-EEG and 1018 W-EEG). IED were detected in 44% of the W-EEG. SD-EEG increased the capacity of the test to detect IED by 35%. IED (not detected in the W-EEG) were detected in 25.1% of the SD-EEG in which spontaneous sleep was achieved. In the group of focal epilepsies, it was found that W-EEG detected IED in 60.1% versus the 79.12% displayed with SD-EEG. In generalised epilepsies this difference was more marked (27.2% and 77.2%, respectively). In patients in whom no IED were detected following an SD-EEG (23.7%) and the clinical suspicion of epilepsy was still high, nocturnal polysomnography was performed and interictal epileptiform activity was observed in 13.6%.
  
  
  CONCLUSIONS
  SD-EEG increases the chances of recording IED by 35% with respect to W-EEG. Sleep deprivation is a method for activating epileptiform paroxysms, regardless of whether the EEG is performed while sleeping or not, although this effect is more pronounced in patients who do manage to sleep.
authors.affiliation: Hospital Regional Universitario de Malaga. Hospital Materno Infantil, Malaga, Espana.
authors.forename: Patricia
authors.initials: P
authors.lastname: Navas
authors.affiliation: Hospital Regional Universitario de Malaga. Hospital Materno Infantil, Malaga, Espana.
authors.forename: Lucía
authors.initials: L
authors.lastname: Rodríguez-Santos
authors.affiliation: Hospital Regional Universitario de Malaga. Hospital Materno Infantil, Malaga, Espana.
authors.forename: Enrique
authors.initials: E
authors.lastname: Bauzano-Poley
authors.affiliation: Andalucia Tech. Centro de Investigaciones Medico-Sanitarias (CIMES). Universidad de Malaga, Malaga, Espana.
authors.forename: José Pablo
authors.initials: JP
authors.lastname: Lara
authors.affiliation: Andalucia Tech. Centro de Investigaciones Medico Sanitarias (CIMES). Universidad de Malaga, Malaga, Espana.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Barbancho
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017286:Polysomnography; D012189:Retrospective Studies; D012494:Sampling Studies; D012892:Sleep Deprivation / Q000503:physiopathology*; D014851:Wakefulness / Q000502:physiology