Relationship between Photoparoxysmal Responses, Daytime of the EEG and Sleep Deprivation
Abstract number :
1.066
Submission category :
Clinical Neurophysiology-Clinical EEG
Year :
2006
Submission ID :
6200
Source :
www.aesnet.org
Presentation date :
12/1/2006 12:00:00 AM
Published date :
Nov 30, 2006, 06:00 AM
Authors :
Tobias Loddenkemper, and Richard C. Burgess
Seizure threshold may be decreased during early morning hours in selected patients with epilepsy. Furthermore, duration of sleep and sleep deprivation may influence epileptogenicity. The photoparoxysmal response (PR) is an indicator for epileptogenicity. No data on susceptibility of PR in relationship to diurnal patterns and sleep deprivation exist. Objectives were to determine the frequency of PR in routine EEGs, to analyze to relationship between PR and daytime of the EEG, and to investigate the effect of sleep deprivation on the occurrence of PR., 31495 consecutive routine EEGs between 1996 and 2005 were reviewed. Patients with emergency EEGs and portable EEGs outside the EEG laboratory were excluded. EEGs were done during three slots before noon (8 am, 9:30 am, 11 am) and during three slots in the afternoon (1:30 pm, 3 pm and 4:30 pm)., PR were seen in 331 out of 31495 EEGs (1.05%). In the adult population, PR occurred in 106 out of 20570 EEGs (0.51%). In the pediatric population, PR were noted in 225 out of 10925 EEGs (2.06%). Patients with PR were significantly younger (19.2 years) as compared to patients without PR (33.6 years) (p[lt]0.001).
208 PR (1.14%) occurred during 18158 EEGs before noon and 129 PR were seen in 13337 afternoon EEGs (0.97%). This trend was only seen in the pediatric patient population with 2.19% PR before noon and 1.83% PR in the afternoon (not significant, p=0.071), whereas no difference between morning and afternoon PR frequencies were seen in the adult population (0.51% and 0.52%, respectively).
Median sleep duration did not differ between patients with and without PR (7 hours). Median sleep duration for children with PR was 7.5 hours and for adults with PR was 7 hours. Patients undergoing a morning EEG slept shorter (median 6 hours) than patients undergoing an EEG in the afternoon (median 8 hours) (p[lt]0.001)., PR was seen more frequently during pediatric routine EEGs as compared to adult EEGs. PR in children occurred more frequently before noon. Results may be related to sleep duration during the night prior to the routine EEG. Although adult and pediatric patients with PR during morning EEGs were significantly more sleep deprived, a mild increase in morning PR frequency was only seen in the pediatric population.,
Neurophysiology