epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLCepilepsia-132Research ArticleSCIENTIFIC SURVEYSНАУЧНЫЕ ОБЗОРЫDIFFERENTIAL DIAGNOSIS OF NOCTURNAL EPILEPTIC AND NONEPILEPTIC PAROXYSMAL PHENOMENA OF SLEEP IN ADULTSДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА НОЧНЫХ ЭПИЛЕПТИЧЕСКИХ И НЕЭПИЛЕПТИЧЕСКИХ ПАРОКСИЗМАЛЬНЫХ ФЕНОМЕНОВ У ВЗРОСЛЫХХачатрянС. Г.KhachatryanS. G.ТунянЮ. С.TunyanYu. S.Ереванский государственный медицинский университет имени Мхетара ГерациАрменияYerevan State Medical University after Mkhitar HeratsiArmeniaНациональный институт здравоохранения имени академика С.Х. Авдалбекяна МЗ РА, ЕреванАрменияNational Institute of Health named after academician S.Kh. Avdalbekyan, YerevanArmenia201308062016535964Copyright © Khachatryan S.G., Tunyan Y.S., 20162016Хачатрян С.Г., Тунян Ю.С.Khachatryan S.G., Tunyan Y.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/132

Abstract: major issues of differentiating epileptic and non-epileptic paroxysmal phenomena of sleep are presented in this article. Quality differentiation is possible in case of good knowledge of semiology of sleep-related epileptic seizure types and epileptic syndromes. Difficulties in identification can lead to further diagnostic mistakes. Parasomnias are the most frequently encountered non-epileptic paroxysmal events in sleep, which are related to both non-rapid-eye movement (NREM) sleep and rapid-eye movement (REM) sleep. NREM-sleep parasomnias are otherwise referred to as arousal disorders. They could be mistaken for frontal lobe epilepsy seizures, which predominantly occur at night and are not readily accompanied by epileptiformabnormalities on EEG. Other sleep phenomena also should be considered in differentiating nocturnal epilepsies. Obstructive sleep apnea, periodic leg movements in sleep and some sleep episodes sometimes are expressed with a pattern hardly distinguishable from epileptic seizures. Complex approach and appropriate diagnostic algorithm would further help clinicians in this field to better assess any given situation.

В статье представлены основные положения дифференциальной диагностики эпилептических и неэпилептических ночных пароксизмальных феноменов. Знание семиологии основных видов эпилептических припадков, встречающихся во время сна, и эпилептических синдромов, которым они присущи, необходимо для их более качественного распознавания. Затруднения при их отличии от других пароксизмов сна могут осложнять диагностику и даже приводить к ошибочным диагнозам. К наиболее часто встречающимся неэпилептическим пароксизмальным феноменам сна относятся парасомнии, которые могут быть связаны с фазой медленного или быстрого сна. Парасомнии фазы медленного сна называются также расстройствами пробуждения, и их часто путают с припадками эпилепсии лобной доли, которые в большинстве своем встречаются ночью и не всегда сопровождаются эпилептиформными изменениями на ЭЭГ. Ряд других феноменов сна также следует учитывать при дифференциации ночных эпилепсий. Эпизоды обструктивного апноэ сна, периодических движений ног во сне и некоторых других феноменов иногда имеют паттерны, сходные с проявлениями эпилепсии. Комплексный подход и соответствующий алгоритм диагностики и ведения помогут лучше оценить ситуацию клиницистами, задействованными в этой области.

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The authors declare that there are no conflicts of interest present.