Sleep influence on seizures and epilepsy effects on sleep in partial frontal and temporal lobe epilepsies.

OBJECTIVES: A reciprocal effect is observed between sleep and epilepsy. Sleep effect on epilepsy is protective and facilitating. Reciprocally epilepsy alters sleep organization and microarchitecture. This interelationship is well established for some epilepsies but remains undefined for cryptogenic and symptomatic frontal and temporal lobe epilepsies. In order to research sleep influence on seizures and epilepsy effects on sleep we carried out two studies in patients with cryptogenic/symptomatic frontal or temporal lobe epilepsies.

METHODS: The occurrence of seizures in relation to the state of alertness was analyzed in patients with (1) mesial temporal and frontal lobe epilepsy, and (2) in patients with mesio-lateral temporal and mesial temporal lobe epilepsy in several conditions. Sleep analysis (organization and microarchitecture) was realized.

RESULTS: We found: (1) a precise relationship between sleep and seizures in frontal lobe epilepsy (FLE); (2) a precise relationship between wakefulness and seizures in temporal lobe epilepsy (TLE); (3) sleep organization was normal in FLE and altered in TLE; (4) alterations of sleep microarchitecture in FLE and TLE.

CONCLUSIONS: Seizure occurrence was mainly in relation to sleep for FLE and to wakefulness for TLE. Sleep organization appeared more altered for TLE than FLE. These results allow practical applications to localize and study FLE and TLE.