[Changes in epileptiform activities during sleep and sleep structures in temporal lobe epilepsy].
We investigated the distribution of epileptiform activities (EA) and ictal discharges, and sleep characteristics in 23 patients with temporal lobe epilepsy (TLE) using polysomnography (PSG) for two consecutive nights. The cassette EEG system devised by our group was employed throughout the study to minimize th untoward effects of overnight recording. The patients consisted of nine men and fourteen women, aged from 17 to 60. Fourteen of them had been taking antiepileptic drugs for long periods of time. The remaining 9 were the untreated patients and examined before and after the commencement of drug therapy. Sleep characteristics of patients were compared to those of age and sex matched healty subjects. The following findings were obtained: 1) EA were found more often during NREM sleep than REM sleep in both treated and untreated patients. The frequency of EA increased in stage 3 + 4 compared to stage 1 or 2. 2) Changes of EA numbers during the consecutive sleep cycles were investigated. Twelve of 14 patients in the treated group showed curves which had decreasing tendency throughout the night. 3) Ictal discharges were observed exclusively in the stage REM or within 10 minutes before and after the REM stage. These phenomena were recognized in both treated and untreated groups. 4) Sleep characteristics of both treated and untreated patients indicated significantly decreased sleep efficiency and increase of % awakening. Moreover, % stage 4 significantly increased in untreated patients compared to healthy subjects. These findings were discussed in terms of the clinical characteristics with TLE and antiepileptic drugs on epileptic activities during sleep as well as sleep structures.
Kohsaka
M
M
Department of Psychiatry and Neurology, Hokkaido University School of Medicine, Sapporo, Japan.
D000293:Adolescent; D000328:Adult; D000368:Aged; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000187:drug effects; D012890:Sleep / Q000502:physiology*