The relationship between severity of epilepsy and sleep disorder in epileptic children

Background: Sleep disturbances are one of the most common behavioral problems in childhood. Sleep problems have an even greater prevalence in children with epilepsy and are one of the most common comorbid conditions in childhood epilepsy.Methods: The present study was a descriptive- correlation study with the general goal of determining the effects of epilepsy on sleep habits of epileptic children in Hamadan, Iran, in 2014. Sampling was done using convenience sampling techniques. Data was collected by using The Early Childhood Epilepsy Severity Scale (E-Chess) and Children’s Sleep Habits Questionnaire (CSHQ). It was analyzed by using SPSS (20) and descriptive and inferential statistics.Results: The mean score of sleep habits were 55/08 ± 6/71. Bedtime resistance (12/14 ± 2/93), parasomnias (11/02 ± 1/84) and sleep anxiety (8/29 ± 2/46) were the most frequent sleep disorders in the studied sample. Based on Pearson’s r, there were significant positive bidirectional relationships between bedtime resistance (rs = 0.129, p < 0.019), parasomnias (rs = 0.298, p < 0.005), sleep disordered breathing (rs = 0.295, p < 0.005), CSHQ total score (rs = 0.144, p < 0.022) on the one hand, and children’s epilepsy severity on the other.Conclusion: Sleep problems should not be overlooked, and a comprehensive review of the sleep habits of this group of patients should be conducted.

Real time PCR Primer Sequences.

<p>Real time PCR Primer Sequences.</p

Percentage of DTZ⁺ cells within total cells in different concentrations of mouse pancreas extract.

<p>The data present the means ± standard deviation (SD) of the means of DTZ⁺ cells derived from P19 EC cells in different concentrations of MPE used in the study. MPE induced the differentiation of P19 EC cells at a higher mean than that of the untreated group (0 µg/ml MPE: negative control). MPE: mouse pancreas extract, DTZ⁺: DTZ-positive cells.</p

DTZ staining of differentiated IPCs, derived from P19 EC cells.

<p>IPCs formed pancreatic islet-like structures (A). A cell cluster distinctly stained crimson red by DTZ is apparent (B). Individual cells are DTZ-positive in spontaneous differentiated EBs (C). Untreated EC cells are not stained (D). Scale bars: A 100 µm, B, C & D 200 µm.</p

Regulatory network of WAC protein.

<p>Regulatory network of WAC protein.</p

Representative micrographs showing morphology of exponentially growing P19 cells at low (A) and high (B) magnification.

<p>Undifferentiated cells are tightly packed polygonal cells, with large nucleoli and high nucleus–cytoplasm ratio. An embroyid body replated on 0.1% gelatin coated petri dish (C) differentiated spontaneously or induced by MPE. The cells spread out from the attached EB. Scale bars: A & C 20 µm, B 10 µm.</p

Fluorescence micrographs illustrating the expression of pancreatic β cell markers.

<p>Staining of IPCs with antibodies against proinsulin+insulin (A) and insulin receptor beta (C) showing that most of the P19 cells treated with MPE express pancreatic β cell markers. (E) Control for immunostaining, the primary antibody was omitted. B, D & F are phase contrast images of the same field shown in A, C & E respectively. Scale bars: 40 µm.</p

Crosstalk between highly co-expressed EP300 transcription factors and WAC protein based on MIR17 (microRNA17).

<p>Crosstalk between highly co-expressed EP300 transcription factors and WAC protein based on MIR17 (microRNA17).</p

Regulatory network of VEZF1 protein.

<p>Regulatory network of VEZF1 protein.</p

Quantitative analysis of genes involved in differentiation of pancreatic cells derived from P19 EC cells.

<p>The cells were cultured as EBs in different concentrations of MPE (mouse pancreas extract). (A) Relative gene expression of PDX-1, INS1, and INS2 in different concentration of MPE. (B) Comparison of expression of Oct3/4, Sox-2, Nanog (undifferentiated stem cell markers), and EP300, CREB1 (differentiated stem cell transcription factors) between P19 EC (embryonal carcinoma) cells and IPCs (insulin-producing cells). The data are expressed as relative gene expression to β-2M and are presented as mean±SD. The means with different letters are significantly different at P = 0.05.</p