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Interviw with Dr. Sergio de Jesús Aguilar Castillo about the relationship between sleep and epilepsy

November 20, 2017

capa dr. sergio aguilar

NN: Doctor, could you tell us about your career?
Dr. Sergio de Jesús Aguilar Castillo: I am a specialist in neurology, neurophysiology and sleep medicine, I graduated from Universidad Autónoma de Campeche and specialized in neurology and neurophysiology at the Universidad Nacional Autónoma de México. Almost 20 years ago, I graduated from the Hospital Centro Médico Nacional Siglo XXI, where I have worked for 14 years as the head of the Department of Neurophysiology.

NN: Doctor, what are the services offered by Centro Médico Siglo XXI?
Dr. Sergio de Jesús Aguilar Castillo: The department of Neurophysiology was implemented in the Hospital Centro Médico Siglo XXI, 14 years ago, aiming to provide specialized care in Neurological diagnosis. We are a reference hospital and as a reference hospital, we receive patients with difficult diagnoses from the southern part of the republic, focusing in EEG, EMG and evoked potentials.

NN: Doctor, could you tell us about the relationship between sleep and epilepsy?
Dr. Sergio de Jesús Aguilar Castillo: Our research areas have focused on two important aspects: One is the identification and categorization of patients with acquired neuropathies such as Guillain-Barré syndrome, and the other major section is electroencephalography.
We have two major areas of interest: One is the epileptic state and epilepsies and the other is epilepsy and the relationship with sleep.
An area of interest that has been awakened lately is the relationship between sleep and epilepsy. It is an area where extra effort has been put on to find the links between the facilitation and presentation of epileptic crises, especially in epilepsies cases of difficult control or diagnosis. Nocturnal frontal epilepsy is one of the difficult cases, which has been under-diagnosed and misdiagnosed as other sleep disorders such as nocturnal paroxysmal dystonia or abnormal movements during sleep. The frontal nocturnal epilepsy is a difficult condition to diagnose and its antecedents come from the ‘70s/’80s; however, it was only in the ‘90s that the disorder could be categorized. This is an epilepsy that is not classified as common due to its symptoms, since the fact that this epilepsy originates in the frontal ovum the characteristics and manifestations are very special.
For example, the patients may have clustering crisis at night and experience rapid atypical crisis and totally uncontrolled movements. These epilepsies, may be confused with other sleep disorders, and in the past it was called paroxysmal epilepsy or paroxysmal nocturnal dysphonia that has been misdiagnosed as REM Sleep Behavior Disorder, or with other movement disorders.

Some publications have shown that nocturnal frontal epilepsy has a genetic determination that makes its characteristics. The diagnosis of nocturnal frontal epilepsy is based mainly on the application of technological tools available at the moment, and not only EEG traces – which most of the time the patient has normal tracing – and when the episode is presented, the electroencephalographic activity is obscured by the number of artifacts that are presented by the sudden movements. Therefore, the relationship and the link that exists between the electro-encephalography and the video are of a vital Importance to identify these
cases, i.e., the study video EEG with the nocturnal registry that we can call the video PSG has been the cornerstone, to identify these disorders.

NN: Doctor, would you recommend Neurovirtual to your colleagues?
Dr. Sergio de Jesús Aguilar Castillo: At our Hospital, Centro Médico Siglo XXI, we have been using the Neurovirtual video EEG for over a year. We have been using the device for two functions: video electro-encephalography for identification of epileptic phenomena, and the other to study coma patients in the ICU and the relationship of vital patterns related to the patient’s state. The Neurovirtual team has been very accessible, their software is user-friendly, and we have found practical tools for understanding of the epileptic phenomenon. The BWIII has been very useful. We work with different specialties within the hospital, mainly in neurology, neurosurgery and intensive therapy. I am also very happy and satisfied that Neurovirtual has a technical support team available 365 days of the year,
and their response is immediate through the telephone, helping us to solve the few inquiries we have had since buying the equipment.

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