Altered polysomnographic profile in juvenile myoclonic epilepsy

Purpose: To study the spectra of steep profile using PSG in a cohort of patients with JME attending a University hospital. Methodology: This prospective cross-sectional case control study involved 25 patients of JME (age: 22.0 +/- 6.3 years; M:F=13:12) on valproic acid (VPA) and 25 matched healthy controls (age: 23.2 +/- 3.04 years; M:F=16:9) were recruited. All patients underwent clinical assessment, electroencephalogram (EEG), and evaluation with sleep questionnaire and PSG. Results: PSG analysis revealed significant alterations in sleep architecture in the JME group in the form of reduced mean sleep efficiency (p=<0.035) and number of patients with reduced sleep efficiency (p=0.001), increased mean sleep onset latency (p=0.04) and number of patients with increased sleep latency (p=0.023), reduced mean N2 sleep percentage (p=0.005) and reduced mean total NREM (non-rapid eye movement) sleep (p=0.001) and increased mean wake percentage (p=0.001). The frequency of arousals, involuntary limb movements, and event related arousals in the JME groups was not different from the controls. Patients >20 years had reduced total sleep time compared to those <20 years (p=0.012). Patients with seizures for >5 years had reduced NREM steep percentage (p=0.042) and those on VPA therapy >1 year had a longer stage 2 (p=0.03) and N3 latency (p=0.03). Patients on <= 600 mg/day of VPA had a higher prevalence of isolated limb movements (p=0.01). Conclusions: PSG revealed significant alterations in sleep architecture in JME despite adequate seizure control. There was variable degree of PSG-phenotypic correlation. (c) 2013 Elsevier B.V. All rights reserved.