Subclinical seizures on EEG with sleep phases and clinical significance in patients with focal epilepsy EEG'de uyku evresinde görülen subklinik nöbetler ve fokal epilepsili hastalarda klinik önemi


Erdoğan Ç., Akbudak İ. H., Doğan E. A.

Pamukkale Medical Journal, cilt.18, sa.2, ss.282-292, 2025 (Scopus) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 18 Sayı: 2
  • Basım Tarihi: 2025
  • Doi Numarası: 10.31362/patd.1503792
  • Dergi Adı: Pamukkale Medical Journal
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.282-292
  • Anahtar Kelimeler: focal epilepsy, sleep, Subclinical seizures
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Purpose: Studies have observed that subclinical seizures significantly impact diagnosis, prognosis, and treatment responses. The aim of our study is to investigate the presence of these seizures, their relationship with sleep, their contribution to diagnosis, and their impact on treatment selection and prognosis in patients diagnosed with partial epilepsy. Materials and methods: A total of 1.626 EEGs conducted in the EEG unit were examined. Among them, 626 were found to belong to patients diagnosed with partial epilepsy. 140 patients who underwent twenty-minute EEG monitoring and 28 patients who underwent twenty-four-hour EEG monitoring were included in the study. Results: A comparative analysis was conducted between two cohorts of patients: one subjected to a twenty-minute EEG and the other undergoing a 24-hour EEG. In the presence of resistant epilepsy, the risk of SCS is increased by 3.1 times. The presence of SCS in frontal lobe epilepsies demonstrated a 2.2-fold elevation compared to temporal lobe epilepsies (1.0-5.3). A statistically significant relationship between Levetiracetam usage and seizures was observed (p=0.044). The calculated Odds Ratio for risk indicated a 1.2-fold (1-1.6) higher frequency of seizures with Levetiracetam usage. Risk analysis revealed a 1.5%-fold (1.2-1.9) higher incidence of seizures with the use of well-known drugs in favor of lacosamide-zonisamide. Conclusion: SCSs are gaining increasing clinical significance in terms of diagnosis, prognosis, and treatment. The relationship between these periods of sleep and SCSs is important for future research with a larger number of patients and medical professionals.