Seizure: May 2012
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Sleep before and after temporal lobe epilepsy surgery
Anna Serafini a,b,, Callixte Kuate c, Philippe Gelisse a,d, Reana Velizarova a, Gian Luigi Gigli b, Philippe Coubes d,e, Arielle Crespel a,d
a Epilepsy Unit, Hoˆpital Gui de Chauliac, Montpellier, France
b Neurology Unit, University-Hospital S. Maria della Misericordia, Udine, Italy
c Neurology department, Laquintinie Hospital, Douala, Yaounde´, Cameroon
d Research Unit ‘‘Movement Disorders’’ (URMA), Department of Neurobiology, Institute of Functional Genomics, CNRS UMR5203 – INSERM U661 – UM1, Montpellier, France
e Service Neurochirurgie, Hoˆpital Gui de Chauliac, Montpellier, France
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Purpose
Patients with epilepsy often complain of non-restorative sleep. This is the consequence of the acute effect of seizures and the chronic effect of epilepsy responsible for disrupting sleep architecture. Other factors such as antiepileptic drugs (AEDs), also play a role in the alteration of sleep organization. The aim of this study was to evaluate the specific effect of seizures and interictal epileptiform abnormalities (IEAs) on sleep, in particular to see whether reducing seizure frequency by epilepsy surgery might improve sleep organization in these patients.
Methods
Eleven patients with refractory mesial temporal lobe epilepsy, who underwent surgical treatment and who were seizure free at the follow-up, were included in the study. Treatment with AEDs was not significantly modified before the second year of follow-up. Patients were evaluated before surgery, at 1-year and 2-year follow-up visits with a videoEEG monitoring (24 h/24). At each follow-up visit, interictal epileptiform abnormalities and sleep macrostructure parameters were assessed.
Results
All patients showed a reduction of their IEAs. At 1-year follow-up, total sleep time and REM sleep increased significantly (p = 0.032 and p = 0.006, respectively). At 2-year follow-up, an important increase of REM sleep was observed (p = 0.028). Most significant variations were noted 1 year after surgery. No significant variations were observed between the first and the second year after surgery.
Conclusions
Surgical treatment of temporal lobe epilepsy may improve sleep macrostructure by reducing the number of seizures and of IEAs. These results indirectly confirm the role of epilepsy in disrupting sleep organization chronically.
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