原发性癫痫合并阻塞性睡眠呼吸暂停低通气综合征的临床特点

目的探讨原发性癫痫合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床特点。方法回顾性分析2007-06-2014-06在我院确诊的16例原发性癫痫合并OSAHS患者的临床资料(包括病史、多导睡眠脑电图及治疗随访)。结果癫痫形式表现为全面强直阵挛发作13例,部分性发作3例,其中夜间发作11例,白天发作5例;多导睡眠脑电图(polysomnography,PSG)显示均为阻塞性睡眠呼吸暂停低通气综合征(OSAHS),其中重度9例,中度4例,轻度3例。所有患者经抗癫痫药物治疗及OSAHS的指导性治疗。其中4例癫痫伴重度OSAHS经单纯药物治疗仍反复发作,联合丙戊酸钠和经鼻持续气道正压通气(CPAP)治疗,随访0.5~3a,发作频率减少3例,发作停止1例。结论原发性癫痫合并OSAHS一般以中老年男性多见,癫痫类型以夜间全面强直阵挛性发作为主,对于单纯抗癫痫药物治疗不佳者,药物联合CPAP治疗可取得明显效果。

Clinical features of obstructive sleep apnea hypopnea syndrome in patients with idiopathic epilepsy

Objective To investigate the clinical characteristics of obstructive sleep apnea hypopnea syndrome(OSAHS) in patients with epilepsy.Methods Clinical data(mainly including history,polysomnography,therapy and follow-up visits) of 16 idiopathic epilepsy cases with OSAHS admitted to our hospital from June 2007 to June 2014 were analyzed retrospectively.Results Of all the 16 cases,generalized tonic-clonic seizures occurred in 13 cases and partial seizures in 3 cases,11 cases happened at night and 5 cases happened in the daytime.Of all patients diagnosed as OSAHS by the monitor of polysomnography,there were 4 severe OSAHS,4 moderate OSAHS and 3 mild OSAHS.Patients with severe OSAHS still repeated seizures after the treatment of simple antiepileptic drugs,but the frequency of seizures decreased in 3 cases and the seizure ceased in 1 case for six months to 3 years follow-up when patients were treated by sodium volproate and continuous positive airway pressure (CPAP).Conclusion OSAHS with epilepsy is much common in middle-aged males.And the main type of seizure is generalized tonic-clonic seizure which usually occurs at night.For patients with worse effect treated by single antiepileptic drug,the combined treatment of antiepileptic drugs and CPAP is more effective.