5. Sleep deprivation in the activation of interictal spikes and epileptic seizures

Abstract

Objective To describe and review the use of sleep deprived EEG in the activation of interictal spikes and epileptic seizures. Background Sleep deprivation (SD) has been used to enhance EEG sensitivity in the diagnosis of epilepsy. However, standardized guidelines for the use of SD-EEGs are lacking. Here, we provide an update in the literature of sleep SD-EEG and epilepsy as well as presenting data from a retrospective study. Design/methods A literature search using PubMed was carried out to identify papers focusing on sleep deprivation EEG and interictal discharges. A total of 39 abstracts were obtained, 13 were screened and included in this review. We also present data from a retrospective study of 156 patients that were assessed with a short and long-monitoring EEG as well as SD-EEG at Son Espases Hospital (Spain) and evaluated their sensitivity in the diagnosis of interictal discharges in patients with suspected epilepsy. Results Further studies are needed to evaluate the role of SD-EEG in patients with suspected epilepsy. In our retrospective study 21% of patients with a previous normal awake EEG showed interictal discharges in the SD-EEG. Conclusions Some studies have shown that SD-EEG increases sensitivity and specificity diagnosing interictal activity. However, the duration of sleep deprivation and length of the test varies according to the different studies. The role of SD-EEG should be further evaluated. The use of subtemporal electrodes may contribute to the diagnosis of temporal lobe epileptiform focus.