Induced Microseizures-A CIinical and Electroencephalographic Study
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Clinical and electroencephalographic investigations were carried out on newly recognized specific microseizures which appeared in relation to increase of anticonvulsants, especially benzodiazepines in 21 cases of the Lennox syndrome.<BR>1) Clinical symptoms were only irregular respiration and opening the eyes without significant increase in muscle tone. Their duration was very short.<BR>2) The ictal EEG showed peculiar bursts of 8 to 18 c/s diffuse hypersynchronous rapid waves.<BR>3) They appeared exclusively in sleep, mostly in moderate and deep sleep.<BR>4) They accompanied sleep abnormalities, such as decrease in the stage REM and poor differentiation of sleep levels after stage 2.<BR>5) They appeared in relation to an increase of benzodiazepines and were suppressed by their decrease or discontinuation. This fact strongly supports the possibility that these seizures are induced by benzodiazepines.<BR>Benzodiazepines have the dual actions as hypnotics and antiepileptics. On the other hand, the remarkable exaggeration of epileptic discharge in sleep indicates the pathophysiology of the Lennox syndrome is closely related to the sleep mechanism. A higher dose of benzodiazepines exceeding the critical level possibly lowers the level of consciousness. It also exerts a stronger hypnotic effect than the expected antiepileptic effect on the epileptic mechanism in the brain, resulting in induction of a new type of specific microseizure.<BR>Unexpected excessive dosage of anticonvulsants used in the intensive treatment of intractable seizures may sometimes evoke a state which is likely to induce microseizures. On such occasions, better therapeutic results can be achieved by a decrease of antiepileptics to an appropriate dosage which would lead not only to a cessation of seizures but also improved mental function.
- 一般社団法人 日本てんかん学会の論文
一般社団法人 日本てんかん学会 | 論文
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