Increased photosensitivity following short sleep in sleep deprived patients.
BACKGROUND
We aimed to determine the effect of short day-time sleep on photoparoxysmal epileptic activity in sleep-deprived patients.


METHODS
We retrospectively reviewed video-EEG recordings performed between 2003 and 2015. All recordings following at least four hours of sleep deprivation, including intermittent photic stimulation (IPS) both before and after sleep with any form of epileptiform activity were included. The study group was divided into four subgroups: (1) no photoparoxysmal response (PPR) group, with epileptiform activities other than PPRs; (2) increment group, with PPR duration increased by ≥200% after vs. before sleep; (3) no significant change group, with PPR duration increased between 50% and 200% after vs. before sleep; (4) decrement group, with PPR duration increased ≤50% after vs. before sleep.


RESULTS
A total number of 5805 EEG recordings from 459 patients was analyzed. Photosensitivity was present in 98 patients (21.4%). The PPRs after sleep were increased in 70% of the photosensitive patients, did not change in 23%, and were decreased in 7%. The increase in duration of PPRs was statistically significant (P<0.001). In our cohort, photosensitivity would have been detected in 67 patients if IPS was applied only before sleep and in 91 patients if IPS was applied only after awakening (P<0.05).


CONCLUSIONS
This study demonstrates that photosensitivity is enhanced after awakening from a short sleep following sleep deprivation. Thus, we recommend performing IPS after awakening to increase sensitivity to detect photoparoxysmal epileptiform discharges.
Istanbul university, Cerrahpasa faculty of medicine, department of neurology, Kocamustafapasa St. No. 53, 34098 Istanbul, Turkey. Electronic address: denizelmali@yahoo.com.
Ayşe Deniz
AD
Elmalı
Istanbul university, Cerrahpasa faculty of medicine, department of neurology, Kocamustafapasa St. No. 53, 34098 Istanbul, Turkey.
Hatice
H
Kurucu
Istanbul university, Cerrahpasa faculty of medicine, department of neurology, Kocamustafapasa St. No. 53, 34098 Istanbul, Turkey.
Özdem
Ö
Ertürk Çetin
Haseki training and research hospital, department of neurology, Istanbul, Turkey.
Özlem
Ö
Çokar
Istanbul Bilim university, department of neurology, Istanbul, Turkey.
Zeliha
Z
Matur
Istanbul university, Cerrahpasa faculty of medicine, department of neurology, Kocamustafapasa St. No. 53, 34098 Istanbul, Turkey.
Ayşin
A
Dervent
Istanbul university, Cerrahpasa faculty of medicine, department of neurology, Kocamustafapasa St. No. 53, 34098 Istanbul, Turkey.
Gülçin
G
Benbir Şenel
Istanbul university, Istanbul faculty of medicine, department of neurology, Istanbul, Turkey.
Candan
C
Gürses
Istanbul university, Cerrahpasa faculty of medicine, department of neurology, Kocamustafapasa St. No. 53, 34098 Istanbul, Turkey.
Veysi
V
Demirbilek
D000293:Adolescent; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D010775:Photic Stimulation; D010787:Photosensitivity Disorders / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies; D012892:Sleep Deprivation / Q000150:complications / Q000503:physiopathology*
Awakening after sleep; EEG; Intermittent photic stimulation; Photoparoxysmal responses; Privation de sommeil; Réponses photoparoxystiques; Réveil après sommeil; Sleep deprivation; Stimulation lumineuse intermittente