Abstracts

Rationale: It is well known the association of sleep deprivation is a risk of seizure recurrence in epileptic patients, however the role of selective patterns of sleep deprivation is yet to be defined in certain epilepsy syndromes. We wanted to evaluate patterns on selective sleep deprivation in patients with juvenile myoclonic epilepsy (JME). Methods: We analyzed sleep deprivation in 2 different forms: Late night sleep delay (LNSD) defined by more than 1.5 hours of the habitual sleep onset time missed, and early morning (EMSD); of 1.5 hours or more missed in the early morning awakening. We compared the recurrence of seizures in a known population of 18 JME patients that fulfilled clinical and neurophysiological criteria, variables associated with sleep schedule and total sleep time were noted. We evaluated the onset of sleep and morning awakening times in periods that included 3-month blocks before the occurrence of seizures. All the patients were compliant with the anti-epileptic treatment. Results: A relationship between all forms of sleep deprivation and seizures was seen in all the patients. LNSD and EMSD were clearly associated with increased frequency and duration of early myoclonic jerks in the first 2 hours after awakening. There was as well increase in seizure frequency with both types of sleep deprivation; however, the most significant predisposing factor was EMSD of 90 minutes or more of the habitual waking time. LNSD and seizures was observed in 25 % of the patients compared to 75% with EMSD (p< 0.01). Conclusions: Sleep deprivation is clearly associated in the generation of seizures in different seizure syndromes. Early sleep morning awakening is a more selective contributor for seizure recurrence than delayed sleep time in patients with Juvenile Myoclonic Epilepsy and this selective deprivation can increase the seizure frequency as much as 3 times more than the late-night sleep. Further testing on other forms of epilepsy is needed. Funding: No funding