A study demonstrates the importance of assessing REM in children with generalized interictal epileptiform discharges (IEDs). as it reveals lateralized epileptogenic spikes. Seizure freedom may be achieved with multilobar resection in these children with generalized IEDs and normal/subtle changes on MRI. Generalized IEDs in children with normal/subtle changes on MRI should not preclude surgical resection 1).

During sleep and wakefulness, REM onsets are associated with distinct intracranial potentials, reminiscent of ponto-geniculate-occipital waves. Individual neurons, especially in the medial temporal lobe (MTL), exhibit reduced firing rates before REMs as well as transient increases in firing rate immediately after, similar to activity patterns observed upon image presentation during fixation without eye movements. Moreover, the selectivity of individual units is correlated with their response latency, such that units activated after a small number of images or REMs exhibit delayed increases in firing rates. Finally, the phase of theta oscillations is similarly reset following REMs in sleep and wakefulness, and after controlled visual stimulation. The results suggest that REMs during sleep rearrange discrete epochs of visual-like processing as during wakefulness 2).

Okanari K, Baba S, Otsubo H, Widjaja E, Sakuma S, Go CY, Jones KC, Nishioka K, Oba S, Matsui T, Ueno M, Ukitsu S, Rutka JT, Drake JM, Donner EJ, Weiss SK, Snead OC 3rd, Ochi A. Rapid eye movement sleep reveals epileptogenic spikes for resective surgery in children with generalized interictal discharges. Epilepsia. 2015 Jul 15. doi: 10.1111/epi.13081. [Epub ahead of print] PubMed PMID: 26174651.
Andrillon T, Nir Y, Cirelli C, Tononi G, Fried I. Single-neuron activity and eye movements during human REM sleep and awake vision. Nat Commun. 2015 Aug 11;6:7884. doi: 10.1038/ncomms8884. PubMed PMID: 26262924.
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