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Role of Continuous Positive Airway Pressure Therapy on the Pathogenesis of Sleep-Related Frontal Lobe Epilepsy in a Child With Obstructive Sleep Apnea Syndrome

Department of Pediatrics, Sleep Centre, University of Rome La Sapienza, S. Andrea Hospital, Rome, Italy

Andrea Pelliccia, MD

Department of Pediatrics, Sleep Centre, University of Rome La Sapienza, S. Andrea Hospital, Rome, Italy

Melania Evangelisti, MD

Department of Pediatrics, Sleep Centre, University of Rome La Sapienza, S. Andrea Hospital, Rome, Italy

Jacopo Pagani, MD

Department of Pediatrics, Sleep Centre, University of Rome La Sapienza, S. Andrea Hospital, Rome, Italy

Maria Pia Villa, MD

Department of Pediatrics, Sleep Centre, University of Rome La Sapienza, S. Andrea Hospital, Rome, Italy, mariapia.villa{at}uniroma1.it

We describe an obese child with severe obstructive sleep apnea syndrome in whom nocturnal frontal lobe seizures developed within a week after therapy was started with continuous positive airway pressure. The video polysomnographic study after the onset of nocturnal episodes showed 3 seizures: 2 starting from slow-wave sleep when he was sleeping with continuous positive airway pressure, and 1 from stage 2 non—rapid eye movement sleep when he was sleeping without continuous positive airway pressure. Cyclic alternating pattern analysis during the video polysomnography recorded after the onset of nocturnal seizures disclosed a high cyclic alternating pattern rate during slow-wave sleep, and the recording obtained after antiepileptic therapy began showed a low cyclic pattern analysis rate. In this child, we describe the non—rapid eye movement sleep instability induced by continuous positive airway pressure therapy might have had a role in triggering the nocturnal seizures.

Key Words: epilepsy • obstructive sleep apnea syndrome • cyclic alternating pattern

This version was published on January 1, 2008

Journal of Child Neurology, Vol. 23, No. 1, 124-128 (2008)
DOI: 10.1177/0883073807308690


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