Abstract
In the last several decades, sleep-related epilepsy has drawn considerable attention among epileptologists and neuroscientists in the interest of new paradigms of the disease etiology, pathogenesis and management. Sleep-related epilepsy is nocturnal seizures that manifest solely during the sleep state. Sleep comprises two distinct stages i.e., non-rapid eye movement (NREM) and rapid eye movement (REM) that alternate every 90 min with NREM preceding REM. Current findings indicate that the sleep-related epilepsy manifests predominantly during the synchronized stages of sleep; NREM over REM stage. Sleep related hypermotor epilepsy (SHE), benign partial epilepsy with centrotemporal spikes or benign rolandic epilepsy (BECTS), and Panayiotopoulos Syndrome (PS) are three of the most frequently implicated epilepsies occurring during the sleep state. Although some familial types are described, others are seemingly sporadic occurrences. In the present review, we aim to discuss the predominance of sleep-related epilepsy during NREM, established familial links to the pathogenesis of SHE, BECTS and PS, and highlight the present available pharmacotherapy options.
Highlights
Epilepsy is characterized by frequent and unpredictable disruptions of brain functions resulting in “epileptic seizures.” Epilepsy has a great impact on the quality of life through increased incidence of injury and death, unemployment rates, lower monthly incomes, higher household costs and high absenteeism at work and schools (Jennum et al, 2017; Trinka et al, 2018; Wibecan et al, 2018)
Sleep related epilepsya anumber of times focal seizure taking place during non-rapid eye movement (NREM) compared to rapid eye movement (REM) stage. anumber of times generalized seizure taking place during NREM compared to REM stage. apredominance of specific sleep related epilepsy during the NREM stages
DEPDC5 (Disheveled, Eg10 and Pleckstrin Domain containing proteins) is a gene that encodes a protein structurally-related to Gap Activity Toward Rags 1 (GATOR1), which is an important negative modulator of mammalian target of Rapamycin Complex 1 that regulates various cell functions (Bar-Peled et al, 2013)
Summary
Epilepsy is characterized by frequent and unpredictable disruptions of brain functions resulting in “epileptic seizures.” Epilepsy has a great impact on the quality of life through increased incidence of injury and death, unemployment rates, lower monthly incomes, higher household costs and high absenteeism at work and schools (Jennum et al, 2017; Trinka et al, 2018; Wibecan et al, 2018). In the pathogenesis of paroxysmal discharge, various predisposing factors (familial vs sporadic) could alter the electrophysiological properties of numerous receptors, which may potentially decrease the extracellular level of Ca2+ and increase the extracellular content of K+, simultaneously (Amzica et al, 2002) Such changes inhibit synaptic transmission and propagation of action potential (Seigneur and Timofeev, 2011), which subsequently impair long-range synchronization and promote electrical coupling between cortical interneurons (Galarreta and Hestrin, 2001) and glial cells (Giaume and McCarthy, 1996).
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