Abstracts

RATIONALE: The reciprocal relation between sleep and epilepsy is well established. This relation differs with epileptic syndromes. Both seizure occurrence during sleep or awakening states and sleep organization appear to be different in partial epilepsies according to the origin of seizure. We have studied the particularities of sleep epilepsy relationship in patients with mesial temporal and frontal lobe epilepsies. METHODS: Twenty patients with clearly defined partial epilepsy underwent the similar protocol with 5 full days video-EEG monitoring. The state of seizure occurrence, the existence of an arousal or not before seizure, and the macro and micro-architecture of sleep were analyzed. RESULTS: A significant difference between frontal lobe epilepsy (FLE)and mesial temporal lobe epilepsy (MTLE) was evidenced as the followings : (1) the occurrence of seizures was found related to sleep in FLE and not in MTLE, (2) sleep seizures in FLE was not preceded by arousal, (3) the rare seizures occurring during sleep in MTLE were preceded by a sudden and brief arousal, (4) the sleep organization in FLE was identical to the control subjects, (5) sleep organization in patients with MTLE was characterized by frequent disruptions and a low efficiency index. CONCLUSIONS: The differences found in relation between sleep and epilepsy in FLE and MTLE suggest the involvement of specific mechanisms. These differences may be used to improve the localization assessment in patients with refractory epilepsy candidates to surgery.