title: The temporal relation between seizure onset and arousal-awakening in temporal lobe seizures.
abstract: OBJECTIVE
  Our main aim was to determine the time interval between the seizure onsets and arousal-awakening related to these seizures in patients with temporal lobe epilepsy (TLE) and to discuss the role of lateralization on arousal-awakening mechanisms.
  
  
  METHODS
  Thirty-three TLE patients who underwent video-EEG monitoring with simultaneous polysomnography (PSG) and had recorded nocturnal seizures were retrospectively examined. These TLE patients had 64 seizures during sleep. The onsets of seizures and arousal-awakening related to these seizures were marked according to clinical and electrophysiological features. The time interval between the seizure onset and arousal-awakening related to the seizure was compared in patients with right- or left-sided temporal lobe seizures.
  
  
  RESULTS
  In our TLE patients nocturnal seizures mostly followed arousal-awakening (64%). The time interval between the seizure onset and arousal-awakening related to the seizure was significantly shorter in patients with left-sided temporal lobe seizures (p=0.01).
  
  
  CONCLUSIONS
  Video-EEG monitoring and PSG with scalp electrodes in our TLE patients showed that nocturnal seizures mostly followed arousal-awakening, and it was more pronounced in those with left-sided seizures. Arousal-awakening might be a signal for subsequent seizures in patients with TLE.
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Neurology, Ankara, Turkey.
authors.forename: Sadiye
authors.initials: S
authors.lastname: Gumusyayla
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Neurology, Ankara, Turkey.
authors.forename: Abidin
authors.initials: A
authors.lastname: Erdal
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Neurology, Ankara, Turkey. Electronic address: irseltezer@yahoo.com.tr.
authors.forename: F Irsel
authors.initials: FI
authors.lastname: Tezer
authors.affiliation: Hacettepe University, Faculty of Medicine, Department of Neurology, Ankara, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Saygi
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000502:physiology*; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012640:Seizures / Q000503:physiopathology*; D013997:Time Factors; D014741:Video Recording; D014851:Wakefulness / Q000502:physiology*; D055815:Young Adult
keywords: Awakening; Hippocampal sclerosis; Polysomnography; Seizure; Sleep; Temporal lobe epilepsy