Insights in Neurosurgery

Sleep Macrostructure in Lennox- Gastaut Syndrome: A Polysomnographic Case-Control Study

Lennox-Gastaut syndrome (LGS) is an epileptic encephalopathy defined by a triad of multiple drug-resistant seizure types, a specific EEG pattern showing bursts of slow spike-wave complexes or generalized paroxysmal fast activity, and intellectual disability. The prevalence of LGS is estimated between 1 and 2% of all patients with epilepsy.

The relationship between sleep disturbances and refractory epileptic encephalopathies (EEs) are still scarce. The aim was to assess, by means of nocturnal polysomnography, if children with LGS present with objective alterations in sleep macrostructure.

33 children with LGS  (21 males; mean age: 7.9 ± 1.4 years) and 33 healthy controls (22 males; mean age: 8.1 ± 1.1 years) underwent an overnight full polysomnography (PSG). Relative to controls, children with LGS showed a significant reduction in all PSG parameters related to sleep duration time in bed (TIB-min; p< 0.001), total sleep time (TST-min; p<0.001), and sleep percentage (SPT-min;  p <0.001), as well as significantly higher REM latency (FRL-min p<0.001), rate in stage shifting (p = 0.005), and number of awakenings/hour (p = 0.002).

Relative to controls, children with EEs also showed significant differences in respiratory parameters (AHI/h, p<0.001; ODI/h, p<0.001; SpO2%, p<0.001; SpO2 nadir%, p<0.001) and a higher rate of periodic limb movements with an index per hour >5 (PLMs%, p<0.001).

Our findings suggest that sleep evaluation could be consideredmandatory in children with Lennox-Gastaut syndrome  in order to improve the clinical management and the therapeutic strategies.

Author(s):

Marco Carotenuto

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