Effect of Treatment of Obstructive Sleep Apnea on Seizure Outcomes in Children With Epilepsy

Besides medicine, what else can you do to reduce seizures in children? Check their sleep! JR

Effect of Treatment of Obstructive Sleep Apnea on Seizure Outcomes in Children With Epilepsy

• Eric Segal, MD
, 
• Martina Vendrame, MD, PhD
, 
• Matthew Gregas, PhD
, 
• Tobias Loddenkemper, MD
, 
• Sanjeev V. Kothare, MD

Department of Neurology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts

Received 22 October 2011; accepted 8 March 2012.

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Abstract 

A retrospective review of children with epilepsy and obstructive sleep apnea, treated surgically for their obstructive sleepapnea from January 2008-October 2010, was performed for age, sex, type of epilepsy, antiseizure medications, sleep-study data, and changes in seizure frequency. Twenty-seven subjects (median age, 5 years) with no adjustment to their medications around their time of surgery were identified. Three months after surgery, 10 (37%) patients became seizure-free, three (11%) demonstrated >50% seizure-reduction, and six (22%) exhibited an amelioration of seizure frequency. Two (7%) demonstrated unchanged seizure-frequency, and six (22%) manifested a worsening of seizure frequency. Median seizure frequency before surgery was 8.5 (interquartile range, 2-90), and after surgery, three (interquartile range, 0-75), with a 53% median seizure reduction. Multivariate analysis demonstrated a trend toward seizure freedom with each percentile increase in body mass index and early age of surgery. We conclude that obstructive sleep apnea surgery may decrease seizure frequency, especially in children with elevated body mass index scores and younger age at time of surgery.

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