title: Effects of antiepileptic treatment on sleep and seizures in nocturnal frontal lobe epilepsy.
abstract: OBJECTIVE
  To study the effects of antiepileptic treatment on sleep parameters and video-polysomnography (VPSG) seizures in nocturnal frontal lobe epilepsy (NFLE).
  
  
  METHODS
  Twenty patients with a clinical and VPSG diagnosis of NFLE (baseline polysomnography [PSG]) underwent a clinical follow-up and performed a second VPSG after effective antiepileptic treatment lasting for at least 6 months. Conventional sleep measures, cyclic alternating pattern (CAP) parameters, and objective VPSG seizures were assessed in NFLE patients before and after treatment and were compared with the results of 20 age- and gender-matched control subjects.
  
  
  RESULTS
  Antiepileptic treatment determined a partial reduction of objective VPSG seizures of approximately 25% compared to baseline condition. Alterations of most conventional sleep measures recovered normal values, but nonrapid eye movement (NREM) sleep instability remained pathologically enhanced (CAP rate, +26% compared to controls) and was associated with persistence of daytime sleepiness.
  
  
  CONCLUSIONS
  Residual epileptic events and high levels of unstable NREM sleep can define a sort of objective resistance of both seizures and disturbed arousal system to the therapeutic purpose of the antiepileptic drugs in NFLE. This finding could determine the need for new therapeutic options in this particular form of epilepsy.
authors.affiliation: Sleep Disorder Center, Department of Neurosciences, Azienda Ospedaliero-Universitaria, Via Gramsci 14, 43126 Parma, Italy. fernandodepaolis@yahoo.it
authors.forename: Fernando
authors.initials: F
authors.lastname: De Paolis
authors.forename: Elena
authors.initials: E
authors.lastname: Colizzi
authors.forename: Giulia
authors.initials: G
authors.lastname: Milioli
authors.forename: Andrea
authors.initials: A
authors.lastname: Grassi
authors.forename: Silvia
authors.initials: S
authors.lastname: Riccardi
authors.forename: Monica
authors.initials: M
authors.lastname: Puligheddu
authors.forename: Mario Giovanni
authors.initials: MG
authors.lastname: Terzano
authors.forename: Francesco
authors.initials: F
authors.lastname: Marrosu
authors.forename: Liborio
authors.initials: L
authors.lastname: Parrino
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D004569:Electroencephalography; D017034:Epilepsy, Frontal Lobe / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020183:Nocturnal Paroxysmal Dystonia / Q000139:chemically induced / Q000175:diagnosis; D017286:Polysomnography; D012894:Sleep Stages / Q000187:drug effects*; D012893:Sleep Wake Disorders / Q000139:chemically induced* / Q000175:diagnosis; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Cyclic alternating pattern (CAP); Minor motor events; Nocturnal frontal lobe epilepsy (NFLE); Seizures; Video-polysomnography