Polysomnographic Aspects of Sleep Architecture on Self-limited Epilepsy with Centrotemporal Spikes: A Systematic Review and Meta-analysis

Self-limited epilepsy with centrotemporal spikes is the most common paediatric epileptic syndrome, with growing evidence linking it to various degrees and presentations of neuropsychological dysfunction. The objective of this study is to evaluate the possible sleep macro and microstructural alterations in children with this diagnosis. A systematic review of published manuscripts was carried out in Medline, LILACS and Scielo databases, using the MeSH terms epilepsy, sleep and polysomnography. From 753 retrieved references, 5 were selected, and data from macro and, when available, microstructure of sleep were extracted. Meta-analysis was performed with data from 4 studies using standardized mean difference. Findings were heterogeneous between studies, being the most frequent macrostructural findings a smaller proportion and greater latency of REM sleep in two studies and, in meta-analysis, a longer sleep latency was the most significant finding among epileptic patients. Only one study evaluated sleep microstructure, suggesting possible alterations in cyclic alternating pattern in diagnosed children. Studies evaluating macro and microstructure of sleep in children with self-limited epilepsy with centrotemporal spikes are necessary to a better understanding of mechanisms of the neuropsychologic disturbances that are frequently seen in children with this diagnosis.

Sleep - Epilepsy - Polysomnography

Publication History

Received: 17 July 2017

Accepted: 20 September 2017

Article published online:
11 October 2023

• REFERENCES

• 1 Guerrini R, Pellacani S. Benign childhood focal epilepsies. Epilepsia. 2012;53 Suppl 4:9-18.
• 2 Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-21.
• 3 Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde Boas W, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010;51(4):676-85.
• 4 Hughes JR. Benign epilepsy of childhood with centrotemporal spikes (BECTS): to treat or not to treat, that is the question. Epilepsy Behav. 2010;19(3):197-203.
• 5 Bouma PA, Bovenkerk AC, Westendorp RG, Brouwer OF. The course of benign partial epilepsy of childhood with centrotemporal spikes: a meta-analysis. Neurology. 1997;48(2):430-7.
• 6 Baglietto MG, Battaglia FM, Nobili L, Tortorelli S, De Negri E, Calevo MG, et al. Neuropsychological disorders related to interictal epileptic discharges during sleep in benign epilepsy of childhood with centrotemporal or Rolandic spikes. Dev Med Child Neurol. 2001;43(6):407-12.
• 7 Kavros PM, Clarke T, Strug LJ, Halperin JM, Dorta NJ, Pal DK. Attention impairment in rolandic epilepsy: systematic review. Epilepsia. 2008;49(9):1570-80.
• 8 Monjauze C, Broadbent H, Boyd SG, Neville BG, Baldeweg T. Language deficits and altered hemispheric lateralization in young people in remission from BECTS. Epilepsia. 2011;52(8):e79-83.
• 9 Northcott E, Connolly AM, Berroya A, McIntyre J, Christie J, Taylor A, et al. Memory and phonological awareness in children with Benign Rolandic Epilepsy compared to a matched control group. Epilepsy Res. 2007;75(1):57-62.
• 10 Beebe DW. Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatr Clin North Am. 2011;58(3):649-65.
• 11 Vriend J, Davidson F, Rusak B, Corkum P. Emotional and Cognitive Impact of Sleep Restriction in Children. Sleep Med Clin. 2015;10(2):107-15.
• 12 Gruber R, Cassoff J, Frenette S, Wiebe S, Carrier J. Impact of sleep extension and restriction on children’s emotional lability and impulsivity. Pediatrics. 2012;130(5):e1155-61.
• 13 Pereira AM, Kaemmerer C, Palmini A, Nunes ML. Avaliação da arquitetura do sono em crianças com epilepsia refratária. J Epilepsy Clin Neurophysiol. 2011;17(1):10-6.
• 14 Pereira AM, Bruni O, Ferri R, Palmini A, Nunes ML. The impact of epilepsy on sleep architecture during childhood. Epilepsia. 2012;53(9):1519-25.
• 15 Panayiotopoulos CP, Michael M, Sanders S, Valeta T, Koutroumanidis M. Benign childhood focal epilepsies: assessment of established and newly recognized syndromes. Brain. 2008;131(Pt 9):2264-86.
• 16 Kellaway P. The electroencephalographic features of benign centrotemporal (rolandic) epilepsy of childhood. Epilepsia. 2000;41(8):1053-6.
• 17 Park JT, Shahid AM, Jammoul A. Common pediatric epilepsy syndromes. Pediatr Ann. 2015;44(2):e30-5.
• 18 Doumlele K, Friedman D, Buchhalter J, Donner EJ, Louik J, Devinsky O. Sudden Unexpected Death in Epilepsy Among Patients With Benign Childhood Epilepsy With Centrotemporal Spikes. JAMA Neurol. 2017;74(6):645-9.
• 19 Tan HJ, Singh J, Gupta R, de Goede C. Comparison of antiepileptic drugs, no treatment, or placebo for children with benign epilepsy with centro temporal spikes. Cochrane Database Syst Rev. 2014(9):CD006779.
• 20 Abou-Khalil BW. Antiepileptic Drugs. Continuum (Minneap Minn). 2016;22(1 Epilepsy):132-56.
• 21 Wheless JW, Clarke DF, Arzimanoglou A, Carpenter D. Treatment of pediatric epilepsy: European expert opinion, 2007. Epileptic Disord. 2007;9(4):353-412.
• 22 Verrotti A, D’Egidio C, Agostinelli S, Parisi P, Chiarelli F, Coppola G. Cognitive and linguistic abnormalities in benign childhood epilepsy with centrotemporal spikes. Acta Paediatr. 2011;100(5):768-72.
• 23 Lewandowski AS, Toliver-Sokol M, Palermo TM. Evidence-based review of subjective pediatric sleep measures. J Pediatr Psychol. 2011;36(7):780-93.
• 24 Terzano MG, Parrino L. Origin and Significance of the Cyclic Alternating Pattern (CAP). REVIEW ARTICLE. Sleep Med Rev. 2000;4(1):101-23.
• 25 Terzano MG, Parrino L, Sherieri A, Chervin R, Chokroverty S, Guilleminault C, et al. Atlas, rules, and recording techniques for the scoring of cyclic alternating pattern (CAP) in human sleep. Sleep Med. 2001;2(6):537-53.
• 26 Bruni O, Novelli L, Luchetti A, Zarowski M, Meloni M, Cecili M, et al. Reduced NREM sleep instability in benign childhood epilepsy with centro-temporal spikes. Clin Neurophysiol. 2010;121(5):665-71.
• 27 Barreto JR, Fernandes RM, Sakamoto AC. Correlation of sleep macrostructure parameters and idiopathic epilepsies. Arq Neuropsiquiatr. 2002;60(2-B):353-7.
• 28 Clemens B, Oláh R. Sleep studies in benign epilepsy of childhood with rolandic spikes. I. Sleep pathology. Epilepsia. 1987;28(1):20-3.
• 29 Gogou M, Haidopoulou K, Eboriadou M, Pavlou E. Sleep Disturbances in Children with Rolandic Epilepsy. Neuropediatrics. 2017;48(1):30-5.
• 30 Rose D, Duron B. [Prognostic value of EEG abnormalities observed during sleep in epilepsy with rolandic spikes (RSE)]. Rev Electroencephalogr Neurophysiol Clin. 1984;14(3):217-26. [Article in French]
• 31 Zhang H, Li Y, Li X, Liu G, Wang B, Li C. Effect of sodium valproate on the sleep structures of epileptic patients. Exp Ther Med. 2014;7(5):1227-32.
• 32 Shvarts V, Chung S. Epilepsy, antiseizure therapy, and sleep cycle parameters. Epilepsy Res Treat. 2013;2013:670682.
• 33 Aneja S, Gupta M. Sleep and childhood epilepsy. Indian J Pediatr. 2005;72(8):687-90.
• 34 Terzano MG, Parrino L, Spaggiari MC, Barusi R, Simeoni S. Discriminatory effect of cyclic alternating pattern in focal lesional and benign rolandic interictal spikes during sleep. Epilepsia. 1991;32(5):616-28.
• 35 De Negri M. Electrical status epilepticus during sleep (ESES). Different clinical syndromes: towards a unifying view? Brain Dev. 1997;19(7):447-51.
• 36 Kramer U, Sagi L, Goldberg-Stern H, Zelnik N, Nissenkorn A, Ben-Zeev B. Clinical spectrum and medical treatment of children with electrical status epilepticus in sleep (ESES). Epilepsia. 2009;50(6):1517-24.
• 37 Nunes ML. Sleep and epilepsy in children: clinical aspects and polysomnography. Epilepsy Res. 2010;89(1):121-5.