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PubMed2003

Living with epilepsy: long-term prognosis and psychosocial outcomes.

OBJECTIVE: To analyze the impact of seizures on everyday life and the long-term effects of epilepsy on health status and psychosocial outcomes. METHODS: Follow-up study was conducted of a cohort of consecutive patients newly diagnosed with epilepsy between 1953 and 1967. In 1995 (mean follow-up 34 years), a random sample of 333 patients received a questionnaire asking clinical and demographic information and validated measures for psychosocial outcomes. Comparisons were made with the general Dutch population. RESULTS: The response rate was 73% (116 men and 127 women); mean age was 49.9 years (SD 11.2 years). Mean age at epilepsy onset was 15 years (SD 11 years); mean duration was 24.4 years (SD 13.1 years). In total, 134 (55%; 72 men and 62 women) patients were seizure-free for the previous 5 years, and 81 patients still had seizures in the last year. One hundred twenty-seven patients were taking antiepileptic drugs, of which 51 were on monotherapy. Epilepsy patients have a positive health evaluation, comparable with the general Dutch population. Fewer epilepsy patients married or had children than the general Dutch population; more patients live at home with their parents or in foster homes or institutions (p < 0.001). Having epilepsy at school age has a significant negative effect on learning achievement (p < 0.01). Employment status is affected less, though more epilepsy patients are unfit to work than individuals from the general population (p < 0.05). CONCLUSIONS: Epilepsy has a marked negative impact on education and achievement in later life. Despite worse psychosocial outcomes than the Dutch population, patients with epilepsy cope well with their epilepsy, regardless of their handicaps.

Activities of Daily Living↗
PubMed2004

Pharmacology of catamenial epilepsy.

Catamenial epilepsy is a menstrual cycle-related seizure disorder characterized by an increase in seizures at the time of menstruation. Catamenial epilepsy affects up to 70% of women with epilepsy. Catamenial seizures are common among women with focal or generalized epilepsy, which affects an estimated 1 million women in the United States. Presently, there is no specific, FDA-approved drug treatment for catamenial epilepsy. Despite the increased use of wide-ranging antiepileptic and hormonal drugs, catamenial seizures are often refractory to many treatments. Recent studies have provided an improved understanding of the pathophysiology of catamenial epilepsy. Cyclical changes of ovarian hormones estrogens and progesterone are now widely believed to be essential for the genesis of catamenial seizures. Generally, progesterone has antiseizure effects, while estrogens facilitate seizure susceptibility. The progesterone metabolite allopregnanolone has been identified as a key endogenous neurosteroid with powerful antiseizure activity. Allopregnanolone is a potent, positive allosteric modulator of GABA(A) receptors. Progesterone and allopregnanolone exposure and withdrawal affects GABA(A) receptor plasticity. In animal models, withdrawal from chronic progesterone and, consequently, of allopregnanolone levels in brain, has been shown to increase seizure susceptibility. Natural progesterone therapy is proven to be effective in women with epilepsy. Consequently, synthetic neurosteroids that are devoid of hormonal side effects represent a novel class of antiepileptic drugs for women with catamenial epilepsy. Our studies suggest that ganaxolone, a GABA(A) receptor-modulating synthetic neuroactive steroid, is a particularly promising treatment for catamenial epilepsy. Future studies are clearly warranted to determine the molecular pathophysiology and an effective treatment of catamenial epilepsy.

Animals↗
PubMed2005

[Qualitative study of hippocampal formation in hypertensive rats with epilepsy].

UNLABELLED: The aim of our study was to investigate the hippocampus and dentate gyrus neuropathological features of spontaneous hypertensive rats (SHR) with epilepsy. METHODS: Animals were randomly divided into 4 groups: control Wistar, Wistar with epilepsy, control SHR and SHR with epilepsy. The pilocarpine model of epilepsy was used in this experiement. After spontaneous recurrent seizures, all animals were perfused and their brains processed for histological analysis through Nissl and neo-Timm methods. RESULTS: In the Wistar rats with epilepsy we observed cell loss in hippocampal subfields CA1, CA3 and hilus of the dentate gyrus when compared with control animals. In the SHR with epilepsy we observed hippocampal formation atrophy with ventricular dilatation. No morphological alterations were observed in SHR and Wistar control rats. The neo-Timm staining of hippocampal formation has shown supragranular sprouting in Wistar and SHR with epilepsy. CONCLUSION We found neuropathological alterations in hippocampal formation in Wistar with epilepsy and SHR with epilepsy, suggesting that epilepsy per se or associated to hypertention are able to cause neuronal damage.

Animals↗
PubMed2003

Positive trends of public attitudes toward epilepsy after public education campaign among rural korean residents.

To assess trends of public attitudes toward epilepsy in Korea, two surveys were performed in the same village using a common questionnaire before and after the schedule of public education on epilepsy. Cross-sectional studies were conducted by means of a door-to-door interview, in which all residents over 19 yr of age living in the survey area were targeted. Vehicles for the educational campaign took the form of lectures and small group discussions. The understanding of epilepsy among Korean respondents appeared to be not only based more on supernatural or superstitious thinking, but was also less comparable to that of other studies. The attitudes toward epilepsy also were far more negative in Korean rural areas than in other countries. The false belief that "epilepsy can not be treated" was the factor that contributed most to negative attitudes. Although a positive trend was obvious not only in understanding the cause of epilepsy but also in attitudes toward epilepsy, the majority of respondents still remain unchanged in their misunderstanding of and negative attitudes toward epilepsy. To ameliorate the social stigma against epilepsy in Korea, continuous and repetitive educational efforts as well as the sympathy of the lay societies regarding epilepsy would be needed.

Adult↗
PubMed1989

Sleep and pediatric epilepsy.

Characteristic of the intimate relationship between sleep and epilepsy are an increase in IEA in nonREM sleep and a decrease in REM sleep, in both generalized and partial epilepsies. The morphology of epileptiform discharges may also be affected by sleep, with a change or breakdown of the generalized pattern in generalized epilepsy, but a better definition of sharp waves in partial epilepsy, during nonREM sleep. One notes a predilection for certain types of epilepsy to occur in sleep, such as benign focal epilepsy of childhood, or to occur shortly after awakening (juvenile myoclonic epilepsy). Epilepsy may disrupt the sleep architecture with an increase in light sleep and a decrease in deep sleep, and an increase in awake time after sleep onset. Sleep is an important activator of IEA and is of value both in the routine EEG evaluation of epilepsy as well as in more prolonged studies used in epilepsy monitoring units.

Child↗
PubMed1996

Descriptive epidemiology of epilepsy: contributions of population-based studies from Rochester, Minnesota.

Studies based on the Rochester Epidemiology Project medical records-linkage system have provided important insights into the epidemiology of epilepsy. The incidence of all convulsive disorders in Rochester, Minnesota, during a 50-year period exceeded 130 per 100,000 person-years. The age-adjusted incidence of epilepsy was 44 per 100,000 person-years; of a first unprovoked seizure, 61; and of acute symptomatic seizures excluding febrile convulsions, 31. In addition, 2% of the population experienced a febrile convulsion before the age of 5 years. The cumulative incidence of epilepsy through age 74 years was 3.0%, of all unprovoked seizures was 4.1%, and of any convulsive disorder approached 10%. For epilepsy, single unprovoked seizures, and acute symptomatic seizures, the incidence was significantly higher in males than in females, and it was high in the first year of life but highest in those age 75 years or older. For epilepsy alone, approximately 60% of incidence cases experienced partial seizures, and two-thirds had no clearly identified antecedent. Cerebrovascular disease was the most commonly identified antecedent of epilepsy, accounting for 11% of cases. Over time, the incidence of epilepsy and of unprovoked seizures decreased in children and increased in the elderly population. The age-adjusted prevalence of active epilepsy on Jan. 1, 1980, was 6.8 per 1,000 residents. Prevalence was low in the first decade of life, increased to a plateau in the adult years, and further increased in the elderly population. Almost 1.5% of the population older than 75 years of age had active epilepsy. About 25% of prevalence cases had an identified cause; 60% experienced partial epilepsy.

Age Distribution↗
PubMed1998

Use of antiepileptic drugs in the treatment of epilepsy in people with intellectual disability.

The main principles of antiepileptic drug treatment of epilepsy in patients with intellectual disability are basically the same as for other patients with epilepsy. However, some specific issues need to be taken into account These are primarily associated with the diagnostic difficulties of epilepsy in this population. In addition, a number of other relevant issues, including the degree and location of brain lesion, the nature of the underlying disease, the higher frequency of difficult-to-treat epilepsies, the additional intellectual impairment caused by inappropriate antiepileptic medication, or by frequent and prolonged seizures, the appropriate use of monotherapy versus rational polytherapy, and the use of broad-spectrum antiepileptic drugs will be discussed in the present paper. Although the goals of treatment are to keep the patient seizure-free and alert while preventing possible mental deterioration, we have to accept compromises between these primary goals in many cases. Some people with epilepsy and intellectual disability are very vulnerable to insidious neurotoxic effects; for example, sedative effects caused by phenobarbital, or cognitive and/or cerebellar dysfunction caused by long-term phenytoin, especially together with other drugs. Because of the adverse effects of phenobarbital and phenytoin, these drugs are no longer recommended as a first-choice drugs when long-term antiepileptic medication is required. In primary generalized tonic-clonic seizures, valproate, oxcarbazepine/carbamazepine and lamotrigine are recommended in this order of preference. The corresponding recommendations are: in typical absences, valproate, ethosuximide and lamotrigine; in atypical absences, valproate and lamotrigine; in juvenile myoclonic epilepsy, valproate, lamotrigine and clobazam; in infantile spasms vigabatrin, ACTH and valproate; in Lennox-Gastaut syndrome, valproate, lamotrigine and vigabatrin; in atonic seizures, valproate and lamotrigine; in simple and complex partial seizures with or without secondary generalization, oxcarbazepine/carbamazepine, valproate/ vigabatrin and lamotrigine; and in status epilepticus lorazepam, diazepam and clonazepam together with phenytoin or fosphenytoin. In cases of poor response to the monotherapy recommended above, the following combinations may be indicated: in primary generalized tonic-clonic epilepsy, valproate and oxcarbazepine/ carbamazepine, or valproate and lamotrigine; in typical absences, valproate and lamotrigine, or valproate and ethosuximide; in juvenile myolonic epilepsy, valproate and lamotrigine, or valproate and clonazepam; and in partial epilepsies, add to the monotherapy one of the following drugs, vigabatrin, lamotrigine, gabapentin, tiagabine, topiramate, zonisamide or clobazam. So far, the order of preference of these new drugs remains undetermined. More data are needed on the efficacy and adverse effects of the new drugs based on controlled studies on patients with intellectual disability and epilepsy.

Anticonvulsants↗
PubMedDate not supplied

[Molecular genetics of epilepsy: present and future implications in clinical practice].

INTRODUCTION: Recent advances in mapping and isolating human epilepsy genes are having an increasing importance in the field of epileptology. DEVELOPMENT AND CONCLUSIONS: As the molecular bases of the genetic epilepsies are elucidated, more precise diagnoses and therapies are possible. Characterization of the genes responsible for several types of epilepsy will allow the clinician to increase diagnostic precision, offer more exact prognoses, and develop more efficient therapies. At the same time, the search for families with several affected members with some form of epilepsy has lead to the description of previously unnoticed epilepsies and epileptic syndromes. Both the precision in diagnosis and the description of new epilepsy syndromes should be of major importance for the development of the next version of the International Classification of Epilepsies and Epileptic Syndromes. Understanding the pathogenic mechanisms involved in different epilepsies may allow the rational development of 'design' antiepileptic drugs and, in the case of the poor-prognosis progressive myoclonus epilepsies, effective gene therapy treatments. Finally, the possibility of offering prenatal diagnosis and genetic counseling to families exposed to some forms of epilepsy may reduce their incidence in the future.

Chromosome Aberrations↗
PubMed1999

[Incidence of epilepsy and epileptic syndromes in children in the province of Albacete].

OBJECTIVE: The purpose of this study was to determine the incidence rate and the relative frequency of epilepsy and epileptic syndromes during childhood in the province of Albacete. PATIENTS AND METHODS: Patients with childhood epilepsy living in the area have been diagnosed in the Neuropediatric Unit at the General Hospital of Albacete. We included patients under 11 years of age with unprovoked recurring epileptic seizures whose first seizure happened between 1-1-1987 and 1-12-1991, excluding those who have only suffered from febrile seizures and other provoked epileptic seizures. RESULTS: In the five-year period of the study, 136 patients from a population of 60,000 children under 11 years of age suffered from epilepsy. The annual incidence rate of epilepsy at this age is 45 in 100,000. For those under 1 year it is 113, for those aged 1 to 5 it is 52, and for those between 6 and 10 years 30. The most common epileptic syndrome is benign childhood epilepsy with centrotemporal spikes (29%), followed by undefined generalized idiopathic epilepsy (16%), symptomatic partial epilepsy (15%) and childhood absence epilepsy (9%). CONCLUSIONS: The epilepsy incidence rates reported here are lower than those found in most studies. Nevertheless, these results agree with some more recent studies. Benign childhood epilepsy with centrotemporal spikes is the most frequent epileptic syndrome during childhood.

Age Distribution↗
PubMedDate not supplied

[Is drug resistant partial epilepsy progressive?].

OBJECTIVES: Approximately one third of the patients with epilepsy are drug resistant. For decades it has been speculated whether repetition of the seizures might potentially lead to progression of the disorder. DEVELOPMENT: In recent years four levels of evidence (experimental, imaging, epidemiological and neuropsychological) suggest that in at least some types of epilepsy the disorder may progress. In various experimental models of epilepsy it has been shown that the persistence of seizures led to biochemical, structural and cellular changes which are persistent and progressive. However, it is difficult to extrapolate these results to human epilepsy. Studies using magnetic resonance volume measurements and spectroscopy have shown that in temporal lobe epilepsy the lesion seems to progress over the years. However, epidemiological and clinical studies do not consistently show a worsening pattern of seizures over the years of epilepsy duration. In fact, recent evidence has shown that drug resistance may occur from the beginning of the disorder. CONCLUSIONS: Neuropsychological studies in patients with drug resistant epilepsy, especially in those with mesial temporal lobe epilepsy, show deterioration of certain cognitive aspects (mainly memory) in relation to the duration and frequency of the partial and secondarily generalized seizures. In case progression of a epilepsy syndrome might be anticipated, this would undoubtedly lead to relevant consequences. If this is so, the therapeutic approach should be more aggressive than at present and might offer early curative treatment, such as epilepsy surgery or neuroprotective drugs, which might halt the progress of the disorder.

Anticonvulsants↗
PubMed2002

The treatment gap and primary health care for people with epilepsy in rural Gambia.

OBJECTIVE: To study primary-level management for people with epilepsy in rural Gambia by means of community surveys. METHODS: After population screening was carried out, visits were made by a physician who described the epidemiology of epilepsy and its management. Gaps between required management and applied management were investigated by conducting interviews and discussions with people with epilepsy and their communities. FINDINGS: The lifetime prevalence of epilepsy was 4.9/1000 and the continuous treatment rate was less than 10%. The choice of treatment was shaped by beliefs in an external spiritual cause of epilepsy and was commonly expected to be curative but not preventive. Treatment rarely led to the control of seizures, although when control was achieved, the level of community acceptance of people with epilepsy increased. Every person with epilepsy had sought traditional treatment. Of the 69 people with active epilepsy, 42 (61%) said they would like to receive preventive biomedical treatment if it were available in their local community. Key programme factors included the local provision of effective treatment and community information with, in parallel, clarification of the use of preventive treatment and genuine integration with current traditional sources of treatment and advice. CONCLUSION: Primary-level management of epilepsy could be integrated into a chronic disease programme covering hypertension, diabetes, asthma and mental health. Initial diagnosis and prescribing could take place away from the periphery but recurrent dispensing would be conducted locally. Probable epilepsy etiologies suggest that there is scope for primary prevention through the strengthening of maternal and child health services.

Anticonvulsants↗
PubMed2002

'A systematic overview--a decade of research'. The information and counselling needs of people with epilepsy.

This paper explores the background to epilepsy in terms of medical impact and psychosocial effects. The argument that information and counselling may be central to the person with epilepsy is explored. The evidence from primary research published between 1990 and 2000 investigating the information and counselling needs of people with epilepsy is appraised and synthesized. This paper seeks to answer the following questions: What are the information and counselling needs of people with epilepsy? What are the preferred formats, timing and delivery of information and counselling? What are the outcomes of information giving and counselling for people with epilepsy? The review suggests that there are unmet needs for personal and general information about epilepsy which may include individual or group education and counselling. Information related to gaining control for people with epilepsy and targeted public education may contribute to improved quality of life for people with epilepsy. Information is required which is individually relevant and could be delivered in small groups or as part of an individual counselling service. Specialist epilepsy clinics and specialist nurses can improve patient knowledge and communication and provide an effective and high quality service for people with epilepsy.

Brain↗
PubMed2002

Refractory epilepsy: diagnosis and management.

Persistence of seizures despite appropriate medical treatment is called refractory epilepsy. Persistent seizures have enormous psychosocial, behavioural and cognitive effects in addition to effects on mortality. Almost 2,40,000 to 3,20,000 patients of refractory epilepsy in India are potential candidates for epilepsy surgery. Causes of refractory or intractable epilepsy are inadequate anti-epileptic treatment, difficulty in treating some epileptic syndromes and difficulty in controlling seizures due to structural brain diseases. Careful evaluation of historical details, especially based on an eyewitness account is the most important aspect in establishing the diagnosis of epilepsy. Raised serum prolactin level helps in differentiating convulsive seizures from non-epileptic convulsions. Video electroencephalographic monitoring is proved effective and efficient mean to establish the rightful diagnosis. Recent developments in neuro-imaging have revolutionised the diagnosis of underlying pathology in patients with refractory epilepsies. Patients with refractory epilepsy should be referred to a specialised epilepsy centre where facilities for epilepsy surgery are available. When medical therapy fails, other options are helpful like use of newer anti-epileptic drugs, vagus nerve stimulation or consideration of epilepsy surgery.

Anticonvulsants↗
PubMedDate not supplied

[Status epilepticus in the course of epilepsy in children and adolescents].

Status epilepticus (SP) is defined as a single seizure or recurrent seizures of over 30 min. duration, without regaining full consciousness. In approximately 50% of cases SE is related to epilepsy. The International League Against Epilepsy has recently proposed a new SE classification (2001). The purpose of this prospective study is to evaluate SE incidence in children and adolescents in relation to their age and type of epilepsy, as well as to determine usefulness of the new classification of SE. A group of 600 children and adolescents with epilepsy was observed prospectively. The inclusion criteria were: recently diagnosed epilepsy in children aged under 15 years, and long-term treatment and observations (mean = 5 years, SD = 3.2). Out of the 600 children and adolescents with epilepsy 39 (6.1%) had one or more episodes during the observation period. Two factors were correlated with SE: age at the onset of epilepsy (under 5 years), and the type of epileptic syndrome (the Lennox-Gastaut syndrome, myoclonic-astatic epilepsy, symptomatic and cryptogenic partial epilepsy, progressive myoclonic epilepsy, and the Kojevnikov syndrome). Only in a fourth of the patients the cause of SP was related to a known factor, such as e.g. infection or sudden discontinuation of anti-epileptic medication. The currently used classification of SP (by Appelton and Gibbs) was found to be more useful than the one newly proposed by ILAE, because the former is better suited to the evaluation of SE in children.

Adolescent↗
PubMed2003

Epilepsy and malformations of the cerebral cortex.

Malformations of the cerebral cortex (MCC) are often associated with severe epilepsy and developmental delay. About 40% of drug-resistant epilepsies are caused by MCC. Classification of MCC is based on embryological brain development, recognising forms that result from faulty neuronal proliferation, neuronal migration and cortical organisation. Hemimegalencephaly, an enlarged dysplastic hemisphere, can present as early onset severe epileptic encephalopathy or as partial epilepsy. In focal cortical dysplasia (FCD), MRI shows focal cortical thickening and simplified gyration. Patients have drug-resistant, often early onset epilepsy. Complete surgical ablation of FCD is accompanied by remission in up to 90% of patients, but may be technically difficult. Tuberous sclerosis (TS) is a multisystemic disorder primarily involving the nervous system; 60% of patients having epilepsy, with 50% having infantile spasms. TS is caused by mutations in the TSC1 and TSC2 genes; 75% of cases are sporadic. TSC1 mutations cause a milder disease. Bilateral periventricular nodular heterotopia (BPNH) consists of confluent and symmetric nodules of grey matter along the lateral ventricles. X-linked BPNH presents with epilepsy in females and prenatal lethality in most males. Most patients have partial epilepsy. Filamin A mutations have been reported in families and sporadic patients. Lissencephaly (LIS smooth brain) is a severe MCC characterised by absent or decreased convolutions. Classical LIS is quite rare and manifests with severe developmental delay, spastic quadriparesis and severe epilepsy. XLIS mutations cause classical lissencephaly in hemizygous males and subcortical band heterotopia in heterozygous females. Thickness of heterotopic band and degree of pachygyria correlate well with phenotype severity. Schizencephaly (cleft brain) has a wide anatomo-clinical spectrum, including partial epilepsy in most patients. Polymicrogyria (excessive number of small and prominent convolutions) has a wide spectrum of clinical manifestations ranging from early onset epileptic encephalopathy to selective impairment of cognitive functions. Bilateral perisylvian polymicrogyria may be familial. Patients present with faciopharingo-glosso-masticatory diplegia and epilepsy, which is severe in about 65% of patients.

Abnormalities, Multiple↗
PubMed2004

Childhood epilepsy: a critical review of cost-of-illness studies.

Epilepsy is an illness with multiple consequences and costs for children, families and society. There are only a few studies published on the cost of childhood epilepsy. The different methodologies used in these studies make it difficult to compare them or even to compare the cost of childhood epilepsy treatment with that of adult epilepsy. Nevertheless, studies highlight important differences in the distribution of costs associated with childhood epilepsy and epilepsy in adults. It is understandable that direct costs represent the higher percentage of the total cost associated with childhood epilepsy treatment, given the higher number of hospital admissions and investigations, as well as the complexity of therapeutic trials, while indirect costs represent the greater proportion in adult epilepsy treatment. In addition to age, the total cost associated with epilepsy also depends on other factors such as seizure frequency, the moment at which the illness cost is estimated and the local health care system. In summary, chronic illnesses not only have an influence on the physical and psychological development of children, they also impose costs on the family and society. Childhood epilepsy has greater economic costs than those generated by more prevalent, chronic illnesses.

Adult↗
PubMed2003

[Surgery of epilepsy in children: who, when, how, and why].

About 25% of epileptic patients continue to suffer from seizures despite adequate anticonvulsant therapy; they are pharmacoresistant. In these patients, the seizures may have a functional impact on their life and render them candidates to epilepsy surgery. Over the past 50 years, epilepsy surgery has been developed and popularized. In the last 15 years, it has been applied to the pediatric epilepsy population. Resistant epilepsy, often catastrophic in children, has important and bad consequences on the intellectual and social development, and may cause secondary brain damage. It is after a presurgical evaluation, aiming at a better comprehension of the epileptic problem as to its origin, propagation and functional impact on the child's psychomotor and social development, that a decision as to the surgical indication can be made. The neurosurgeon has different surgical therapeutic strategies, varying according to the type of epilepsy, the anatomical regions involved and the eventual post-operative functional impact. Thirty children have so far had the benefit of epilepsy surgery in the romand epilepsy surgical program. Multiple surgical techniques have been applied: lesionectomy, lobectomy, cortectomy, hemispherotomy, stereoelectroencephalography, subdural electrodes. The pathological substrate in paediatric epilepsy surgery is often related to cerebral developmental abnormalities. More than 75% of operated children have remained seizure free since surgery and many are on reduced medication. Subsequently to seizure cessation and reduction of medication, improvement in cognitive functions, behaviour and social integration can be witness. In some pharmacoresistant epilepsy of childhood, epilepsy surgery should not be considered the treatment of last resort, but rather the treatment of choice.

Adolescent↗
PubMed2005

[Relationship between idiopathic epilepsy and sleep macrostructure in children].

OBJECTIVE: To evaluate the relationship between epilepsy and sleep macrostructure in children. METHODS: Totally 31 children with idiopathic epilepsy aged 6-13 (mean 9.5) years were enrolled in this study, including 18 with idiopathic focal epilepsy and 13 with idiopathic generalized epilepsy. Sixteen age-and gender-matched children were also included as the control group. Polysomnogram (PSG) was recorded in all the children for analysis. RESULTS: Children with idiopathic partial epilepsy had increased total recording time (P<0.05) and those with idiopathic generalized epilepsy exhibited reduced non-rapid eye movement sleep in comparison with the control group. The efficiency of the different phases in the total sleep was also lowered in children with idiopathic generalized epilepsy (P<0.05), whose total sleep time had also been significantly reduced (P<0.05). CONCLUSIONS: Significant changes occur in the sleep macrostrcture of children with idiopathic epilepsy. Children with idiopathic generalized epilepsy presents poorer sleep quality, whereas those with idiopathic partial epilepsy tend to require excessive time for sleep.

Adolescent↗