Abstracts

Rationale: We studied the effect of epilepsy on sleep and sleep on epileptiform discharges' using sleep questionnaires and PSG in patients with JME.Methods: Twenty patients with JME [10 on valproate (Group I - 22 4.2 years; M:F=4:6); and 10 drug-na ve (Group II - 21.6 4.6 years; M:F=4:6)] underwent assessment with Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and over-night PSG and scalp-EEG. Epileptiform discharges (EDs) were quantified in different sleep stages. ED Index was derived as number of EDs/minute per stage. SPSS vs. 11 was used for statistical analysis. A P <0.05 was considered as statistically significant.Results: There was no significant difference in ESS/PSQI scores between the groups. Patients on valproate (Group I) had increased time in bed, were often in N1, N2 and N3; had increased latency to N1 and N2; more arousals and higher arousal index compared to group II. Other PSG parameters were not different in both groups. Routine EEG revealed EDs in 11/20 (Group I: 4; Group II:7) patients. Eighteen patients had EDs in various sleep-stages during PSG (Group I&II 9 each)- N1: 13, N2: 16, N3: 13 and REM: 10. The ED index was highest during N1/N2 followed by N3/REM, and was higher in group I. The EDs were frequently associated with arousals in N1/N2, and K-complexes in N2. There was no other significant difference between groups I and II. Conclusions: Patients with JME on valproate had altered sleep architecture. Epileptiform activity was observed more often in sleep than wakefulness. Sleep stages had variable effect on EDs with light-sleep having a facilitatory effect, especially in valproate group