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Schlaf und Epilepsie

Sleep and epilepsy

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Zusammenfassung

Schlafqualität bzw. Schlafstörungen und Epilepsie sind in verschiedener Hinsicht inhaltlich miteinander verbunden: Treten im Schlaf komplexe Bewegungsmuster bei fehlendem oder eingeschränktem Bewusstsein auf, geht es um die differenzialdiagnostische Einordnung dieser Episoden und deren Zuordnung als epileptische oder nichtepileptische Korrelate. Klagen auf der anderen Seite an Epilepsie Erkrankte über nichterholsamen Schlaf oder das vermehrte Auftreten nächtlicher epileptischer Anfälle, gilt es, dezidiert nach Komorbiditäten zu fahnden, die entweder epilepsieunabhängig einen verminderten Erholungswert des Schlafes bedingen oder aber durch spezifische Arousal das vermehrte Auftreten nächtlicher Anfälle triggern. Zudem darf nicht außer Acht gelassen werden, dass verschiedene Antiepileptika Nebenwirkungen haben können, die die Schlafqualität mindern oder aber Symptome eines nichterholsamen Schlafes wie beispielsweise Tagesmüdigkeit, Konzentrationsstörungen oder Stimmungsschwankungen hervorrufen können. Trotz eingehender Anamnese und Fremdanamnese gelingen die artdiagnostische Zuordnung nächtlicher Bewegungssequenzen und die Klärung möglicher kausaler Zusammenhänge oft erst mithilfe spezifischer diagnostischer Verfahren wie der polysomnographischen Untersuchung im Schlaflabor oder mittels Video-EEG-Langzeitmonitoring (EEG: Elektroenzephalogramm). Ziel dieses Übersichtsbeitrags ist es, die klinisch relevanten schlafgebundenen Bewegungsstörungen differenzialdiagnostisch vorzustellen und die häufigsten Ursachen spezifischer Arousal im Schlaf abzugrenzen.

Abstract

The quality of sleep or sleep disorders and epilepsy are linked to each other in various respects: if complex movement patterns occur during sleep with a lack of or limited consciousness, the differential diagnosis of these episodes requires classification as either epileptic or non-epileptic correlates. If, however, patients with epilepsy complain about unrestful sleep or an increased incidence of nocturnal epileptic seizures, it is necessary to search for potential comorbidities that might either reduce the recreational value of sleep independent of epilepsy or trigger an increased incidence of nocturnal seizures through specific arousal. Additionally, it must not be disregarded that various antiepileptic drugs may cause side effects that can reduce sleep quality or cause symptoms of unrestful sleep, such as daytime drowsiness, concentration impairments or mood swings. Despite a thorough patient anamnesis and third party reports, the diagnostic classification of nocturnal movement sequences and the clarification of possible causal relationships are often only achievable with the help of specific diagnostic procedures, such as polysomnographic examinations in a sleep laboratory or with the use of a video electroencephalogram (EEG) long-term monitoring. The aim of this review article is to present the clinically relevant sleep-related movement disorders with a view to the differential diagnostics and to demarcate the most common causes of specific arousal in sleep.

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  1. Abteilung Neurologie, Universitätsklinikum Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland

    Johannes Schiefer

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  1. Johannes Schiefer
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Schiefer, J. Schlaf und Epilepsie. Z. Epileptol. 31, 12–21 (2018). https://doi.org/10.1007/s10309-017-0156-8

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