Postictal generalized EEG suppression and respiratory dysfunction following generalized tonic –clonic seizures in sleep and wakefulness

Summary ObjectiveSudden unexpected death in epilepsy (SUDEP) is a common cause of death in epilepsy and frequently occurs following generalized tonic–clonic seizures (GTCS) in sleep. Postictal generalized electroencephalography (EEG) suppression (PGES), postictal immobility, and periictal respiratory dysfunction are potential risk factors for SUDEP. We sought to determine whether there was a difference in respiratory dysfunction, PGES, and postictal immobility for GTCS occurring during wakefulness or sleep. MethodsWe retrospectively analyzed video‐EEG telemetry data in the epilepsy‐monitoring unit. Patients’ state at seizure onset and seizure characteristics were identified. Respiratory parameters and heart rate were recorded. Presence and duration of PGES and time to first postictal nonrespiratory movement were recorded. ResultsThere were 165 seizures in 67 patients. There was no significant difference in the duration of postictal immobility in GTCS occurring out of wakefulness or sleep (p = 0.280). Oxygen desaturation nadir (p = 0.572) and duration of oxygen desaturation were not significantly different for GTCS starting during sleep or wakefulness (p = 0.992). PGES occurred more frequently when seizure onset was in sleep than in wakefulness (p = 0.004; odds ratio [OR] 2.760). There was no difference in the duration of PGES between the two groups. SignificancePGES occurs more commonly after GTCS in sleep than in wakefulness but, in the epilepsy‐monitoring...
Source: Epilepsia - Category: Neurology Authors: Tags: Full ‐Length Original Research Source Type: research