title: Sleep before and after temporal lobe epilepsy surgery.
abstract: OBJECTIVE
  Patients with epilepsy often complain of non-restorative sleep. This is the consequence of the acute effect of seizures and the chronic effect of epilepsy responsible for disrupting sleep architecture. Other factors such as antiepileptic drugs (AEDs), also play a role in the alteration of sleep organization. The aim of this study was to evaluate the specific effect of seizures and interictal epileptiform abnormalities (IEAs) on sleep, in particular to see whether reducing seizure frequency by epilepsy surgery might improve sleep organization in these patients.
  
  
  METHODS
  Eleven patients with refractory mesial temporal lobe epilepsy, who underwent surgical treatment and who were seizure free at the follow-up, were included in the study. Treatment with AEDs was not significantly modified before the second year of follow-up. Patients were evaluated before surgery, at 1-year and 2-year follow-up visits with a videoEEG monitoring (24h/24). At each follow-up visit, interictal epileptiform abnormalities and sleep macrostructure parameters were assessed.
  
  
  RESULTS
  All patients showed a reduction of their IEAs. At 1-year follow-up, total sleep time and REM sleep increased significantly (p=0.032 and p=0.006, respectively). At 2-year follow-up, an important increase of REM sleep was observed (p=0.028). Most significant variations were noted 1 year after surgery. No significant variations were observed between the first and the second year after surgery.
  
  
  CONCLUSIONS
  Surgical treatment of temporal lobe epilepsy may improve sleep macrostructure by reducing the number of seizures and of IEAs. These results indirectly confirm the role of epilepsy in disrupting sleep organization chronically.
authors.affiliation: Epilepsy Unit, Hôpital Gui de Chauliac, Montpellier, France. serafini_anna@libero.it
authors.forename: Anna
authors.initials: A
authors.lastname: Serafini
authors.forename: Callixte
authors.initials: C
authors.lastname: Kuate
authors.forename: Philippe
authors.initials: P
authors.lastname: Gelisse
authors.forename: Reana
authors.initials: R
authors.lastname: Velizarova
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Gigli
authors.forename: Philippe
authors.initials: P
authors.lastname: Coubes
authors.forename: Arielle
authors.initials: A
authors.lastname: Crespel
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology