難治性癲癇與阻塞性睡眠呼吸暫停的研究進展_Journal of Epilepsy

Authors：

王璐 ,  陳陽美

重慶醫科大學附屬第二醫院神經內科（重慶 400010）;

Corresponding?author：

陳陽美, Email: 300249@cqmu.edu.cn

Keywords：

難治性癲癇; 阻塞性睡眠呼吸暫停; 危險因素

DOI：

10.7507/2096-0247.20190073

Video：

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Abstract Full text Figures/Tables Video References Cited by

癲癇是神經系統的常見疾病，其中約 20%～40% 的癲癇患者為難治性癲癇，嚴重影響著患者的生活質量及生命安全。既往研究已發現，阻塞性睡眠呼吸暫停（Obstructive sleep apnea，OSA）是難治性癲癇的常見共患病，二者相互影響，加重患者病情。相關研究表明，控制 OSA 癥狀不僅可以降低癲癇發作頻率，還可有效改善患者白天嗜睡、提高患者生活質量，早期識別并治療 OSA 可以改善癲癇患者預后并降低癲癇患者死亡率。現將難治性癲癇及 OSA 的流行病學、病理生理基礎、評估及治療的相關進展作一綜述，為臨床相關疾病的診治提供一定參考。

Citation： 王璐, 陳陽美. 難治性癲癇與阻塞性睡眠呼吸暫停的研究進展. Journal of Epilepsy, 2019, 5(6): 454-457. doi: 10.7507/2096-0247.20190073 Copy

1.	Trinka E, Kwan P, Lee B, et al. Epilepsy in Asia: disease burden, management barriers, and challenges. Epilepsia, 2019, 60(Suppl 1): 7-21.
2.	Neligan A, Hauser WA, Sander JW. The epidemiology of the epilepsies. Handb Clin Neurol, 2012, 107(1): 113-133.
3.	Kwan P, Schachter SC, Brodie MJ. Drug-resistant epilepsy. N Engl J Med, 2011, 365(10): 919-926.
4.	Khachatryan SG, Prosperetti C, Rossinelli A, et al. Sleep-onset central apneas as triggers of severe nocturnal seizures. Sleep Med, 2015, 16(8): 1017-1019.
5.	McCarter AR, Timm PC, Shepard PW, et al. Obstructive sleep apnea in refractory epilepsy: a pilot study investigating frequency, clinical features, and association with risk of sudden unexpected death in epilepsy. Epilepsia, 2018, 59(10): 1973-1981.
6.	Lin Z, Si Q, Xiaoyi Z. Obstructive sleep apnoea in patients with epilepsy: a meta-analysis. Sleep Breath, 2017, 21(2): 263-270.
7.	Epstein LJ, Kristo D, Strollo PJ, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med, 2009, 5(3): 263-276.
8.	De Backer W. Obstructive sleep apnea/hypopnea syndrome. Panminerva Med, 2013, 55(2): 191-195.
9.	中華醫學會呼吸病學分會睡眠呼吸障礙學組. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南(2011年修訂版). 中華結核和呼吸雜志, 2012, 35(1): 9-12.
10.	Li P, Ghadersohi S, Jafari B, et al. Characteristics of refractory vs. medically controlled epilepsy patients with obstructive sleep apnea and their response to CPAP treatment. Seizure, 2012, 21(9): 717-721.
11.	Yildiz FG, Tezer FI, Saygi S. Temporal lobe epilepsy is a predisposing factor for sleep apnea: a questionnaire study in video-EEG monitoring unit. Epilepsy Behav, 2015, 48(4): 1-3.
12.	Malow BA, Levy K, Maturen K, et al. Obstructive sleep apnea is common in medically refractory epilepsy patients. Neurology, 2000, 55(7): 1002-1007.
13.	Jain SV, Simakajornboon S, Shapiro SM, et al. Obstructive sleep apnea in children with epilepsy: prospective pilot trial. Acta Neurol Scand, 2012, 125(1): e3-6.
14.	Bateman LM, Li CS, Seyal M. Ictal hypoxemia in localization-related epilepsy: analysis of incidence, severity and risk factors. Brain, 2008, 131(Pt 12): 3239-3245.
15.	Nakase K, Kollmar R, Lazar J, et al. Laryngospasm, central and obstructive apnea during seizures: defining pathophysiology for sudden death in a rat model. Epilepsy Res, 2016, 128: 126-139.
16.	Sivathamboo S, Perucca P, Velakoulis D, et al. Sleep-disordered breathing in epilepsy: epidemiology, mechanisms, and treatment. Sleep, 2018, 41(4): 1-15.
17.	Zanzmera P, Shukla G, Gupta A, et al. Markedly disturbed sleep in medically refractory compared to controlled epilepsy-a clinical and polysomnography study. Seizure, 2012, 21(7): 487-490.
18.	Vendrame M, Auerbach S, Loddenkemper T, et al. Effect of continuous positive airway pressure treatment on seizure control in patients with obstructive sleep apnea and epilepsy. Epilepsia, 2011, 52(11): e168-171.
19.	Latreille V, Willment KC, Sarkis RA, et al. Neuropsychological correlates of obstructive sleep apnea severity in patients with epilepsy. Epileptic Disord, 2019, 21(1): 78-86.
20.	Foldvary-Schaefer N, Andrews ND, Pornsriniyom D, et al. Sleep apnea and epilepsy: who's at risk? Epilepsy Behav, 2012, 25(3): 363-367.
21.	Jain SV, Horn PS, Simakajornboon N, et al. Obstructive sleep apnea and primary snoring in children with epilepsy. J Child Neurol, 2013, 28(1): 77-82.
22.	Devinsky O, Hesdorffer DC, Thurman DJ, et al. Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention. Lancet Neurol, 2016, 15(10): 1075-1088.
23.	Chihorek AM, Abou-Khalil B, Malow BA. Obstructive sleep apnea is associated with seizure occurrence in older adults with epilepsy. Neurology, 2007, 69(19): 1823-1827.
24.	Malow BA, Foldvary-Schaefer N, Vaughn BV, et al. Treating obstructive sleep apnea in adults with epilepsy: a randomized pilot trial. Neurology, 2008, 71(8): 572-577.
25.	Upadhyay H, Bhat S, Gupta D, et al. The therapeutic dilemma of vagus nerve stimulator-induced sleep disordered breathing. Ann Thorac Med, 2016, 11(2): 151-154.
26.	Zambrelli E, Saibene AM, Furia F, et al. Laryngeal motility alteration: a missing link between sleep apnea and vagus nerve stimulation for epilepsy. Epilepsia, 2016, 57(1): e24-27.
27.	Salvade A, Ryvlin P, Rossetti AO. Impact of vagus nerve stimulation on sleep-related breathing disorders in adults with epilepsy. Epilepsy Behav, 2018, 79(2): 126-129.
28.	Parhizgar F, Nugent K, Raj R. Obstructive sleep apnea and respiratory complications associated with vagus nerve stimulators. J Clin Sleep Med, 2011, 7(4): 401-407.
29.	Kataria L, Vaughn BV. Sleep and Epilepsy. Sleep Med Clin, 2016, 11(1): 25-38.
30.	Carotenuto M, Parisi P, Esposito M, et al. Sleep alterations in children with refractory epileptic encephalopathies: a polysomnographic study. Epilepsy Behav, 2014, 35(1): 50-53.
31.	Foldvary-Schaefer N. Sleep complaints and epilepsy: the role of seizures, antiepileptic drugs and sleep disorders. J Clin Neurophysiol, 2002, 19(6): 514-521.
32.	Weatherwax KJ, Lin X, Marzec ML, et al. Obstructive sleep apnea in epilepsy patients: the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) is a useful screening instrument for obstructive sleep apnea in a disease-specific population. Sleep Med, 2003, 4(6): 517-521.
33.	Chiu HY, Chen PY, Chuang LP, et al. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: a bivariate meta-analysis. Sleep Med Rev, 2017, 36(3): 57-70.
34.	Pornsriniyom D, Kim H, Bena J, et al. Effect of positive airway pressure therapy on seizure control in patients with epilepsy and obstructive sleep apnea. Epilepsy Behav, 2014, 37(1): 270-275.
35.	Winslow DH, Bowden CH, DiDonato KP, et al. A randomized, double-blind, placebo-controlled study of an oral, extended-release formulation of phentermine/ topiramate for the treatment of obstructive sleep apnea in obese adults. Sleep, 2012, 35(11): 1529-1539.
36.	Eskandari D, Zou D, Karimi M, et al. Zonisamide reduces obstructive sleep apnoea: a randomised placebo-controlled study. Eur Respir J, 2014, 44(1): 140-149.
37.	Segal E, Vendrame M, Gregas M, et al. Effect of treatment of obstructive sleep apnea on seizure outcomes in children with epilepsy. Pediatr Neurol, 2012, 46(6): 359-362.
38.	Zanzmera P, Shukla G, Gupta A, et al. Effect of successful epilepsy surgery on subjective and objective sleep parameters—a prospective study. Sleep Med, 2013, 14(4): 333-338.

1. Trinka E, Kwan P, Lee B, et al. Epilepsy in Asia: disease burden, management barriers, and challenges. Epilepsia, 2019, 60(Suppl 1): 7-21.
2. Neligan A, Hauser WA, Sander JW. The epidemiology of the epilepsies. Handb Clin Neurol, 2012, 107(1): 113-133.
3. Kwan P, Schachter SC, Brodie MJ. Drug-resistant epilepsy. N Engl J Med, 2011, 365(10): 919-926.
4. Khachatryan SG, Prosperetti C, Rossinelli A, et al. Sleep-onset central apneas as triggers of severe nocturnal seizures. Sleep Med, 2015, 16(8): 1017-1019.
5. McCarter AR, Timm PC, Shepard PW, et al. Obstructive sleep apnea in refractory epilepsy: a pilot study investigating frequency, clinical features, and association with risk of sudden unexpected death in epilepsy. Epilepsia, 2018, 59(10): 1973-1981.
6. Lin Z, Si Q, Xiaoyi Z. Obstructive sleep apnoea in patients with epilepsy: a meta-analysis. Sleep Breath, 2017, 21(2): 263-270.
7. Epstein LJ, Kristo D, Strollo PJ, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med, 2009, 5(3): 263-276.
8. De Backer W. Obstructive sleep apnea/hypopnea syndrome. Panminerva Med, 2013, 55(2): 191-195.
9. 中華醫學會呼吸病學分會睡眠呼吸障礙學組. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南(2011年修訂版). 中華結核和呼吸雜志, 2012, 35(1): 9-12.
10. Li P, Ghadersohi S, Jafari B, et al. Characteristics of refractory vs. medically controlled epilepsy patients with obstructive sleep apnea and their response to CPAP treatment. Seizure, 2012, 21(9): 717-721.
11. Yildiz FG, Tezer FI, Saygi S. Temporal lobe epilepsy is a predisposing factor for sleep apnea: a questionnaire study in video-EEG monitoring unit. Epilepsy Behav, 2015, 48(4): 1-3.
12. Malow BA, Levy K, Maturen K, et al. Obstructive sleep apnea is common in medically refractory epilepsy patients. Neurology, 2000, 55(7): 1002-1007.
13. Jain SV, Simakajornboon S, Shapiro SM, et al. Obstructive sleep apnea in children with epilepsy: prospective pilot trial. Acta Neurol Scand, 2012, 125(1): e3-6.
14. Bateman LM, Li CS, Seyal M. Ictal hypoxemia in localization-related epilepsy: analysis of incidence, severity and risk factors. Brain, 2008, 131(Pt 12): 3239-3245.
15. Nakase K, Kollmar R, Lazar J, et al. Laryngospasm, central and obstructive apnea during seizures: defining pathophysiology for sudden death in a rat model. Epilepsy Res, 2016, 128: 126-139.
16. Sivathamboo S, Perucca P, Velakoulis D, et al. Sleep-disordered breathing in epilepsy: epidemiology, mechanisms, and treatment. Sleep, 2018, 41(4): 1-15.
17. Zanzmera P, Shukla G, Gupta A, et al. Markedly disturbed sleep in medically refractory compared to controlled epilepsy-a clinical and polysomnography study. Seizure, 2012, 21(7): 487-490.
18. Vendrame M, Auerbach S, Loddenkemper T, et al. Effect of continuous positive airway pressure treatment on seizure control in patients with obstructive sleep apnea and epilepsy. Epilepsia, 2011, 52(11): e168-171.
19. Latreille V, Willment KC, Sarkis RA, et al. Neuropsychological correlates of obstructive sleep apnea severity in patients with epilepsy. Epileptic Disord, 2019, 21(1): 78-86.
20. Foldvary-Schaefer N, Andrews ND, Pornsriniyom D, et al. Sleep apnea and epilepsy: who's at risk? Epilepsy Behav, 2012, 25(3): 363-367.
21. Jain SV, Horn PS, Simakajornboon N, et al. Obstructive sleep apnea and primary snoring in children with epilepsy. J Child Neurol, 2013, 28(1): 77-82.
22. Devinsky O, Hesdorffer DC, Thurman DJ, et al. Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention. Lancet Neurol, 2016, 15(10): 1075-1088.
23. Chihorek AM, Abou-Khalil B, Malow BA. Obstructive sleep apnea is associated with seizure occurrence in older adults with epilepsy. Neurology, 2007, 69(19): 1823-1827.
24. Malow BA, Foldvary-Schaefer N, Vaughn BV, et al. Treating obstructive sleep apnea in adults with epilepsy: a randomized pilot trial. Neurology, 2008, 71(8): 572-577.
25. Upadhyay H, Bhat S, Gupta D, et al. The therapeutic dilemma of vagus nerve stimulator-induced sleep disordered breathing. Ann Thorac Med, 2016, 11(2): 151-154.
26. Zambrelli E, Saibene AM, Furia F, et al. Laryngeal motility alteration: a missing link between sleep apnea and vagus nerve stimulation for epilepsy. Epilepsia, 2016, 57(1): e24-27.
27. Salvade A, Ryvlin P, Rossetti AO. Impact of vagus nerve stimulation on sleep-related breathing disorders in adults with epilepsy. Epilepsy Behav, 2018, 79(2): 126-129.
28. Parhizgar F, Nugent K, Raj R. Obstructive sleep apnea and respiratory complications associated with vagus nerve stimulators. J Clin Sleep Med, 2011, 7(4): 401-407.
29. Kataria L, Vaughn BV. Sleep and Epilepsy. Sleep Med Clin, 2016, 11(1): 25-38.
30. Carotenuto M, Parisi P, Esposito M, et al. Sleep alterations in children with refractory epileptic encephalopathies: a polysomnographic study. Epilepsy Behav, 2014, 35(1): 50-53.
31. Foldvary-Schaefer N. Sleep complaints and epilepsy: the role of seizures, antiepileptic drugs and sleep disorders. J Clin Neurophysiol, 2002, 19(6): 514-521.
32. Weatherwax KJ, Lin X, Marzec ML, et al. Obstructive sleep apnea in epilepsy patients: the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) is a useful screening instrument for obstructive sleep apnea in a disease-specific population. Sleep Med, 2003, 4(6): 517-521.
33. Chiu HY, Chen PY, Chuang LP, et al. Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: a bivariate meta-analysis. Sleep Med Rev, 2017, 36(3): 57-70.
34. Pornsriniyom D, Kim H, Bena J, et al. Effect of positive airway pressure therapy on seizure control in patients with epilepsy and obstructive sleep apnea. Epilepsy Behav, 2014, 37(1): 270-275.
35. Winslow DH, Bowden CH, DiDonato KP, et al. A randomized, double-blind, placebo-controlled study of an oral, extended-release formulation of phentermine/ topiramate for the treatment of obstructive sleep apnea in obese adults. Sleep, 2012, 35(11): 1529-1539.
36. Eskandari D, Zou D, Karimi M, et al. Zonisamide reduces obstructive sleep apnoea: a randomised placebo-controlled study. Eur Respir J, 2014, 44(1): 140-149.
37. Segal E, Vendrame M, Gregas M, et al. Effect of treatment of obstructive sleep apnea on seizure outcomes in children with epilepsy. Pediatr Neurol, 2012, 46(6): 359-362.
38. Zanzmera P, Shukla G, Gupta A, et al. Effect of successful epilepsy surgery on subjective and objective sleep parameters—a prospective study. Sleep Med, 2013, 14(4): 333-338.

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