Nocturnal Paroxysmal Motor Events Associated with EEG Changes in Frontal Seizures Versus Temporal Seizures and Normal Subjects.
Abstract number :
1.095
Submission category :
Year :
2001
Submission ID :
2710
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
P. Charpentier, Neurology; H. Sediri; J-M. Jacquesson; P. Derambure, Clinical Neurophysiology, CHRU, Lille, France
RATIONALE: Interactions between epilepsy and sleep are explored by a number of recent studies. Sleep can have a facilitating or a protective effect on epileptic seizures. Some electroclinical patterns observed during sleep suggest a continuum from nocturnal dystonic manifestations associated with micro-arousals to motor partial seizures. We were interested by the brief paroxystic muscular tonus increasing associated with EEG changes observed during sleep in epileptic patients. To quantify and to characterize the nocturnal paroxysmal motor events (NPME) in patients with partial epilepsy.
METHODS: 99 subjects were included in this prospective study: 73 epileptic patients (37 with Frontal Lobe Epilepsy and 36 with Temporal Lobe Epilepsy (TLE)) and 26 controls. They all underwent a Video polysomnography. NPMEs were classified in 4 types:
Type I: brief electromyographic tonus enhancement followed by EEG arousal; II: muscular tonus increasing with EEG slow waves or spikes; III: prolonged movement recorded in EMG channels ([gt]10s) with synchronised delta or Theta waves, autonomic dysregulation; IV: NPME of any type followed by true electroclinical partial seizure.
RESULTS: The total number of NPMEs was increased in epileptic patients compared to controls. The difference reaches a high degree of probability for type II and III. The total number of NPMEs was increased (p[lt]0.05) in the sub-group with active epilepsy compared to no-active (10.7[plusminus]7.1 versus 7.5[plusminus]4.9). The number of NPMEswas associated to a nocturnal activation of the epilepsy and to the severity of the epilepsy.
CONCLUSIONS: Systematic study of micro-arousals and other transitory electromyographic changes observed in polysomnography have lead to confirm that they are increased in partial epilepsy. These results suggest that cortical activation by deep structures implied in awakening plays a key role in epilepsy. NPMEs are easy to detect by spectral analysis and they could have an interest in diagnosis, classification and prognosis for partial epilepsy.