1,720,995 research outputs found
REM sleep behaviour disorder in elderly subjects with epilepsy: Frequency and clinical aspects of the comorbidity
No full textPurpose: To evaluate the clinical aspects of REM sleep behaviour disorder (RBD) occurring in elderly people with epilepsy, and the frequency of this comorbidity. Methods: Eighty epilepsy patients aged 60 or over (47 men; mean age 70.7 ± 7.1) were screened for episodes of RBD. Those whose clinical and video-polysomnographic findings met the relevant ICSD-2005 criteria received a definite diagnosis of RBD. Results: Undiagnosed or misdiagnosed episodes of idiopathic RBD were found to coexist with epilepsy in 10 out of the 80 (12.5%) subjects investigated. RBD occurred more frequently in the men (p < 0.04) than in the women, and in those with cryptogenic epilepsy (p < 0.05). The RBD episodes pre-dated seizure onset by 4.5 years in six subjects and post-dated seizure onset by 9.7 years in the others, and were more likely to occur in patients with sleep-related seizures. Conclusions: Undiagnosed or misdiagnosed RBD can coexist with epilepsy in the elderly. Increased awareness of this potential comorbidity may help to prevent misdiagnosis and incorrect treatment of affected patients. The ultimate neurobiological meaning of the coexistence of RBD and seizures is still unclear. The two conditions could co-occur by chance; alternatively they may both be underlain by neurodegenerative processes. In cases of seizures during sleep the two disorders may, hypothetically, also show interactions (similarly to what has been documented in feline models of generalised and focal epilepsy with REM sleep "without atonia" and "without EEG desynchrony" induced by pontine dissociation techniques. © 2007 Elsevier B.V. All rights reserved
REM sleep behavior disorder and epileptic phenomena: Clinical aspects of the comorbidity
No full textPurpose: To document the occurrence of REM sleep behavior disorder (RBD) episodes in patients with epilepsy, and of interictal EEG epileptiform abnormalities (IEA) in patients with idiopathic RBD. Methods: Consecutive observations in a tertiary epilepsy center and a tertiary sleep center. RBD diagnosis was based on standard clinical and video-polysomnographic findings. Results: Co-occurrence of epileptic seizures and RBD episodes was found in six cases (all men; mean age 70.5 ± 11.1 years). Focal, isolated, sporadic sharp waves during wakefulness and/or during sleep were documented in 9 out of 34 (26.4%) patients with idiopathic RBD; no significant differences in age at onset and duration of RBD emerged between RBD patients with and without IEA. Conclusions: RBD episodes can occur in epilepsy patients and focal IEA in patients with idiopathic RBD. This, apart from being a possible cause for misdiagnosis, may indicate a possible link between the two disorders. Further systematic investigations of the occurrence of RBD episodes in epilepsy will help to establish the real extent of this comorbidity and its ultimate neurobiological significance. © 2006 International League Against Epilepsy
Non-convulsive status epilepticus and generalised tonic-clonic seizures ersisting in old age in a patient with idiopathic generalised epilepsy: A long-term observation
No full textPersisting non-convulsive status epilepticus in a man with idiopathic generalised epilepsy is reported. After a first generalised tonic/clonic seizure on awakening one day at the age of 20, the patient experienced rare nonconvulsive status epilepticus until the age of 73, when the frequency of the episodes increased, in spite of the initiation of treatment with antiepileptic drugs. No significant cognitive decline was documented when the patient was 83. The existence of such conditions in the context of idiopathic generalised epilepsy shows the problems of syndromic diagnosis and of age dependency of some epileptic phenomena over the course of life with potential bidirectional influences between epileptic manifestations and senile processes © Springer-Verlag Italia 2006
Recurrent confusional states with PLEDs in elderly: Report of three cases
No full textTerzano et al reported a confusional state with neurological manifestations in seven elderly patients with PLEDs on the EEG and normal brain imaging in all but one patients. The cases of three elderly patients (73, 76 and 90 years old) with acute confusional state, focal seizures and PLEDs are reported; differencies respect to previous reports discussed
REM Sleep Behaviour Disorder in oversixty epilepsy patients: Frequency of occurrence and features of comorbidity
No full textFrequency of occurrence of REM Sleep Behaviour Disorder (RBD) and the features of RBD-epilepsy co-morbidity were investigated in 74 elderly epilepsy patients (44 men; mean age 70.8 years). Co-existence of RBD was documented in 10 out of the 74 subjects, with RBD episodes preceding seizures onset, in six cases, by a mean of 5.7 years. The RBD episodes significantly prevailed in men and tended to occur more frequently in over-seventy subjects with cryptogenic epilepsy and sleep-related seizures
Erratum: Non-convulsive status epilepticus and generalised tonic - Clonic seizures persisting in old age in a patient with idiopathic generalised epilepsy: A long-term observation (Neurological Sciences (2007) vol. 27 (6) (436-348))
No full textInterictal, potentially misleading, epileptiform EEG abnormalities in REM sleep behavior disorder
No full textStudy Objectives: To examine the implications of interictal epileptiform abnormalities (IEA) in idiopathic REM-sleep behavior disorder (RBD), particularly the risk of misdiagnosing RBD episodes as epileptic nocturnal seizures. Design: Observational analysis and review. Setting: Tertiary sleep center. Patients: Thirty patients (28 men; mean age 66.3 ± 7.5 years) referred to our sleep unit for a definite diagnosis of nocturnal sleep-related motor and behavioral paroxysmal episodes. Interventions: N/A. Measurements and Results: All the patients were found to be affected by idiopathic RBD according to standard clinical and videopolysomnographic criteria. IEA(sporadic, fronto-temporal sharp-waves) were detected in 8 subjects (26.6%) during routine electroencephalogram and/or nocturnal in-lab videopolysomnography with extended EEG montages. In 2 of these 8 patients, IEA occurred during REM sleep. Conclusions: When only the clinical history is considered, RBD episodes may be confused with nocturnal epileptic focal seizures. The presence of IEA either on routine awake electroencephalograms, or during sleep electroencephalograms, may add support for a diagnosis of epileptic nocturnal seizures. Our data show that IEA may occur in wake and sleep (non rapid eye movement and rapid eye movement sleep) tracings of subjects with episodes of idiopathic RBD. However full-night extended electroencephalogram montages and polysomnography recording of an episode proved useful in establishing a definite diagnosis of RBD in these potentially misleading cases. Comparison of the patients' demographic data and RBD features revealed no differences between RBD with IEA and without IEA. On this basis-and given that these abnormalities have also been described in elderly people with wakefulness-related nonepileptic disorders-IEA in RBD could simply be interpreted as a nonspecific phenomenon, probably related to brain aging
Seizures originating from the temporal lobe and sleep: Clinical and prognostic value of different association pictures
No full textSleep-related seizures were reported in 64.8% of 111 subjects affected by temporal lobe epilepsy (49 men, 62 women, mean age 47 years, range: 2-60), patients with seizures only during sleep accounting for just 3.6% of the cases. Patients with seizure at onset during sleep, were charactherized, with respect to those with seizure at onset during wakefulness, by further occurrence of subsequent sleep-related seizures in the course of the disease, more frequent secondary generalization of focal seizures and more frequent co-existence of sleep-apnea
Hallucinations and sleep-wake cycle in Alzheimer's disease: A questionnaire-based study in 218 patients
No full textThe aim was to evaluate the relationship between hallucinations and the sleep-wake cycle in a sample of Alzheimer's disease (AD) patients in the early-moderate stage. Two hundred and eighteen AD patients (66 males, 152 females, mean age 74.3±6.85) were administered a sleep questionnaire in the presence of a care-giver. Twenty-six out of 218 (12%) reported the occurrence of hallucinations, mainly visual. In 18/28 (69%) hallucinations occurred when the patient was awake and in 8 (31%) hallucinations were reported to occur close to a specific phase of the sleep-wake cycle. Vivid dreams were reported in 25/218 (11%) and violent sleep-related and dream-related behaviours (probable REM behaviour episodes) in 22/218 (10%). Both REM phenomena were more frequent in AD hallucinators than in AD non-hallucinators (26.9% vs. 9.3%, and 26.9% vs. 7.8%, p<0.007). Our data indicate a lower incidence of hallucinations and presumable REM behaviour disorder (RBD) in AD, at least in the early-moderate phase, than that observed in synucleinopathies. However, the higher occurrence of vivid dreams and RBD in AD patients with hallucinations compared to those without hallucinations indicates a potential role of disordered REM sleep in influencing the occurrence of hallucinations in AD, similar to what has been observed in synucleinopathies. © Springer-Verlag Italia 2007
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