The Influence Of Epileptiform Discharges In Spontaneous Night Sleep And Study Of Quality Of Life In Adult Epileptic Patients

Part I The influence of epileptiform discharges in spontaneous night sleep in adult patientsObjective:To evaluate the influence of epileptiform discharges on sleep and quality of life in patients with different types of seizures,we observed the number of epileptiform discharges(EDs)in each stage of sleep.Methods:120 epileptic patients were recruited from January 2011 to December 2014 in the second affiliated hospital of Soochow university special epilepsy outpatient.The basic clinical data and etiology were gathered from them.On one hand,according to the results of 24h V-EEG,all patients were divided into three groups,namely the epileptiform discharge group,the non-epileptic abnormality group,and the control.Chi-square test was used to determine the inspection of EDs in wakefullness and different sleep stages among these three groups.On the other hand,according to the results of PSG,We analyzed the changes in sleep architecture and sleep parameters in these three groups.Compared with those with normal brain electrical activity on sleep used Chi-square test.Further,to explore whether there was a distinguish among sleep stages,time quantitative analysis and comparison was done for each sleep stage in various kinds of seizure types.Results:Thirty of all subjects may have etiology while ninety may not have.The non-epileptic abnormalities were observed in 25 patients of 120 ones(25.8%)and EDs were detected in 52 patients(43.3%),among which EDs were detected in 32(61.5%)subjects both in sleep and wakefulness;EDs were found only in 15 subjects during sleep,and 5 subjects only during wakefullness.Together,the EDs detection rate during wakefulness and sleep was significantly different(p<0.05).Compared with patients who had normal brain electrical activity on sleep,the duration of NREM 1～2 sleep were prolonged(65.93±9.1%and 58.67±5.7%)and NREM 3 were shortened(17.78±5.2%and 26.06±8.2%)in the epileplic patients with EDs.The duration of REM sleep latency definitely prolonged(89.34±15.4min和78.38±16.5min)as the times of awakening increased(42.54±17.8 and 51.56±19.5)in patients who had EDs while the duration of REM sleep latency and the times of awakening were similar between the non-epileptic abnormality patients and patients who had normal brain electrical activity on sleep.Different types of epileptic seizures were no significant difference in sleep architecture.Conclusions:EDs are leading to fragmented sleep which seriously affect epileptic patients’ sleep so that sleep quality decreases obviously.The combination of V-EEG with PSG is a useful method to detect EDs during sleep and to analyze the association among EDs sleep-wake cycles for clinical treatment of epilepsy.Part II Study of quality of life in adults with epilepsy and analysis of related factorsObjective:To evaluate the quality of life(QOL)and its related factors in adults with epilepsy.Methods:One-hundred and thirty-two patients who met the criteria were divided into 3 groups according to seizure types including partial seizures,genaralised seizures and absence.We collected patients’ basic data,including gender,age,age of onset,duration,attack frequency,education,occupation,examination and AED types,etc.The quality of life in people with epilepsy-31(QOLIE-31)was administered to 132 adults with epilepsy and 30 healthy volunteers who had the similar personal characters.Chi-square test was used to determine the difference between the control group and patients in different groups.We analyzed the relationship between QOL and possible factors such as gender,age,age of onset,duration,seizure frequency,education,occupation,examination and antiepileptic drugs.The optimal factors were selected and the regression equation were established by introduction of multiple factors and stepwise regression such as seizure frequency,medication categories,marriage.Results:The quality of life in patients suffered different types of attacks were poorer than the control and the difference was statistically significant(p<0.01).The genaralised seizure group had the same effects on drugs as other types and its other indicators got lower score than rest groups with statistically different(p<0.05).Different seizure types bear the influence of drugs in patients with no obvious difference.Seizure frequency had the greatest impact on QOL and record of formal schooling took the second place,at the same time,kinds of medication and marriage also had influence.Conclusion:Quality of life in epilepsy patients was significantly poorer than healthy people.Genaralised seizures had greater effect on quality of life than partial seizures.Effective control of seizure frequency and improvement of enducation may improve the epilepsy patients quality of life.