Some Peculiar Aspects of Frontal Lobe Epilepsy and Sleep Apnea Syndrome When the Two Diseases Coexist.
Abstract number :
1.096
Submission category :
Year :
2001
Submission ID :
2965
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
A. Crespel, MD, Epilepsy Unit, Gui de CHAULIAC Hospital, Montpellier, France; P. Gelisse, MD, Epilepsy Unit, Gui de CHAULIAC Hospital, Montpellier, France; B. Carlander, MD, Sleep Unit, Gui de CHAULIAC Hospital, Montpellier, France; P. Coubes, MD, Epileps
RATIONALE: The relationships between sleep apnea syndrome (SAS) and epilepsy are well established. Sleep deprivation increases the risk of recurrent seizures. Nocturnal seizures may be triggered by hypoxemia. In frontal lobe epilepsy (FLE), seizures most often occurred during sleep. We thus decided to investigated patients diagnosed with FLE and SAS in order to evaluate the semiological aspects of these two diseases and their relationships.
METHODS: Monitoring video-EEG (10/20 system), polysomnography, Epworth[scquote]s scale, Beck[scquote] inventory depression scale, psychiatric evaluation according the DSM-IV were performed in all cases.
RESULTS: Four male patients have been studied. Seizure started before the SAS in all. Precipitating factors included deleterious effects of benzodiazepines and/or barbiturates on breathing, and weight gain induced by valproate. All complained an excessive daytime sleepiness. Obstructive apnea syndrome was diagnosed in all (apnea index between 60-80 per hours). Only one was obese. All had personality disorders. They had nocturnal seizures with violence and aggressive behavior in the post ictal period. Interictal nocturnal sleep EEG was unremarkable. An improvement of sleep and daytime sleepiness after antiepileptic drug adjustment and CPAP treatment was obtained.
CONCLUSIONS: In these patients with FLE, the SAS appears severe, substantially differs from the classic form and coexist with personality disorders. Agitation in the post-ictal period is the most striking finding. These observations suggest that this association may be related and must be evidenced by further observations.