Öz
Amaç
Nörolojide en çok görülen hastalıklar arasında epilepsi ve uyku ile ilişkili solunum bozuklukları (USB) yer almaktadır. Çalışmamızda primer horlama-epilepsi (PrH-E) ile ağır obstruktif uyku apne sendromu-epilepsi (OUAS-E) birlikteliği olan hastalarda uyku parametrelerinin karşılaştırmasının yanı sıra, her iki klinikte uygulanan tedavilerin birbirlerine olan etkisinin değerlendirilmesi amaçlandı.
Gereç ve Yöntem
2006-2022 yılları arasında kurumumuz uyku laboratuvarı ve epilepsi polikliniğinde takip edilen hastalar etik kurul onayı sonrası retrospektif olarak incelendi. USB tedavisi öncesi ve sonrası demografik veriler, tıbbi öykü, epileptik nöbetlerin özellikleri, elektroensefalogramlar (EEG) ve antiepileptik ilaç (AEİ) tedavileri karşılaştırıldı. Ek olarak, USB tedavisi sonrası AEİ’nin doz ve sayısının azaltılmasının uyku yapısı ve solunum yolu üzerindeki etkileri değerlendirildi.
Bulgular
Çalışmaya 28 PrH-E hastası ve 28 ağır OUAS-E hastası dahil edildi. Farkındalığın bozulduğu fokal başlangıçlı bilateral tonik-klonik nöbetler her iki grupta daha sık bulundu. USB tedavisini takiben, her iki grupta da nöbet şiddeti ve sıklığında bir azalma, EEG patolojilerinde bir azalma veya AEİ’lerin sayısında ve dozlarında azalma vardı. AEİ’lerdeki azalma ve USB tedavisi, uyku yapısında iyileşme, vücut kitle indeksinde düşüş, horlama ve Epworth Uykululuk Ölçeği skorlarında bir azalma ile sonuçlandı.
Sonuç
Uykuda solunum bozukluklarının tedavisiyle AEİ’nin sayısı ve dozu azalmakta, uyku yapısı düzelmekte ve horlama yakınması azalmaktadır. Çalışmamızda tedavi ile hem epilepsi hem de USB kliniklerinde karşılıklı düzelmeler saptanmıştır. Epilepsili hastalarda USB ile ilişkili şikayetler ve USB’li hastalarda ise olası epileptik nöbet varlığı sorgulanmalıdır.
Anahtar Kelimeler: Obstruktif uyku apne sendromu, primer horlama, epilepsi, antiepileptik ilaç, vücut kitle indeksi, Epworth Uykululuk Ölçeği
Kaynakça
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