Vol 8, No 2 (2013)

Physiologic patterns of sleep on EEG can sometimes be similar to epileptiform activity and even to the EEG pattern of epileptic seizures, but they have no connection to epilepsy and their incorrect interpretation may lead to overdiagnosis of epilepsy. These sleep patterns include vertex transients, K-complexes, hypnagogic hypersynchrony, 14 and 6 Hz positive bursts, wicket-potentials, etc. The main distinctive features of acute physiological phenomena of sleep unlike epileptiform activity are stereotyped, monomorphic morphology of waves, which frequently has rhythmic, arcuate pattern, often with change of lateralization, mainly dominated in the first stages of sleep (N1-N2), with their reduction in the deeper stages and transition to delta sleep (N3). The correct interpretation of physiological sharp-wave phenomena of sleep on EEG requires considerable training and experience of the physician. Our review includes a variety of physiological sleep patterns, which can mimic epileptiform activity on EEG, their criteria of diagnostic with demonstration of own illustrations of EEG.

The authors propose a fundamental review, devoted to the factors, wich increase the risk of suicidal behavior (suicidal ideation and suicide attempts) in patients with epilepsy. It is known, that suicidal risk is increased 5 times more in patients with epilepsy, and 25 times more in patients with temporal lobe epilepsy and complex focal seizures, than in general population. The main factors, increasing suicidal risk in epilepsy, are comorbid affective disorders (depression), and psychosis. The authors also describe the role of antiepileptic drugs.

Benign paroxysmal torticollis of infancy – a rare condition, characterize by episodes of torticollis with duration from several hours to several weeks, which appears in healthy children and is self-limited. It is proposed that this condition is predictor of migraine and connected with mutations in CACNA 1A and PRRT2. Differential diagnosis of benign paroxysmal torticollis includes, first of all, epilepsy. The article includes a short review and own description of 6 cases.