一些癫痫综合征(睡眠相关的癫痫,SREs)与睡眠有很强的联系。合并症睡眠障碍在SRE患者中很常见,会对癫痫发作控制和生活质量产生负面影响。我们的目的是定义可能有SRE的患者的诊断途径的标准程序(方案1)以及SRE和睡眠障碍合并症患者的一般管理(方案2)。
该项目是在欧洲神经病学会的主持下进行的,欧洲睡眠研究协会和欧洲国际抗癫痫联盟。该框架包含以下阶段:临床情景的概念;文献综述;关于标准程序的陈述。对于文献检索,采用了从系统评价到初步研究的逐步方法。已发表的研究来自美国国家医学图书馆的MEDLINE数据库和Cochrane图书馆。
情况1:尽管证据质量低,针对特定的SRE,提供了有关记忆记忆评估的建议以及在家中或实验室捕获事件的工具。情况2:早期诊断和治疗SRE患者的睡眠障碍(尤其是呼吸系统疾病)可能有利于癫痫发作的控制。
缺乏评估SRE患者的明确程序。提供的建议可能有助于标准化和改进特定SRE的诊断方法。强调了识别和治疗特定睡眠障碍对于SRE患者的管理和结果的重要性。
Some epilepsy syndromes (sleep-related epilepsies, SREs) have a strong link with sleep. Comorbid sleep disorders are common in patients with SRE and can exert a negative impact on seizure control and quality of life. Our purpose was to define the standard procedures for the diagnostic pathway of patients with possible SRE (scenario 1) and the general management of patients with SRE and comorbidity with sleep disorders (scenario 2).
The project was conducted under the auspices of the European Academy of Neurology, the European Sleep Research Society and the International League Against Epilepsy Europe. The framework entailed the following phases: conception of the clinical scenarios; literature review; statements regarding the standard procedures. For the literature search a stepwise approach starting from systematic reviews to primary studies was applied. Published studies were identified from the National Library of Medicine\'s MEDLINE database and Cochrane Library.
Scenario 1: Despite a low quality of evidence, recommendations on anamnestic evaluation and tools for capturing the event at home or in the laboratory are provided for specific SREs. Scenario 2: Early diagnosis and treatment of sleep disorders (especially respiratory disorders) in patients with SRE are likely to be beneficial for seizure control.
Definitive procedures for evaluating patients with SRE are lacking. Advice is provided that could be of help for standardizing and improving the diagnostic approach of specific SREs. The importance of identifying and treating specific sleep disorders for the management and outcome of patients with SRE is underlined.