Effects of antiepileptic treatment on sleep and seizures in nocturnal frontal lobe epilepsy.

Abstract

OBJECTIVE:

To study the effects of antiepileptic treatment on sleep parameters and video-polysomnography (VPSG) seizures in nocturnal frontal lobe epilepsy (NFLE).

METHODS:

Twenty patients with a clinical and VPSG diagnosis of NFLE (baseline polysomnography [PSG]) underwent a clinical follow-up and performed a second VPSG after effective antiepileptic treatment lasting for at least 6 months. Conventional sleep measures, cyclic alternating pattern (CAP) parameters, and objective VPSG seizures were assessed in NFLE patients before and after treatment and were compared with the results of 20 age- and gender-matched control subjects.

RESULTS:

Antiepileptic treatment determined a partial reduction of objective VPSG seizures of approximately 25% compared to baseline condition. Alterations of most conventional sleep measures recovered normal values, but nonrapid eye movement (NREM) sleep instability remained pathologically enhanced (CAP rate, +26% compared to controls) and was associated with persistence of daytime sleepiness.

CONCLUSIONS:

Residual epileptic events and high levels of unstable NREM sleep can define a sort of objective resistance of both seizures and disturbed arousal system to the therapeutic purpose of the antiepileptic drugs in NFLE. This finding could determine the need for new therapeutic options in this particular form of epilepsy.

• Authors: Fernando De Paolis, Elena Colizzi, Giulia Milioli, Andrea Grassi, Silvia Riccardi, Monica Puligheddu, Mario Giovanni Terzano, Francesco Marrosu, Liborio Parrino
• Journal: Sleep medicine (Sleep Med) Vol. 14 Issue 7 Pg. 597-604 (Jul 2013) ISSN: 1878-5506 [Electronic] Netherlands
• PMID: 23746822 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier B.V. All rights reserved.

Chemical References

• Anticonvulsants

Topics

• Adult
• Anticonvulsants (administration & dosage, adverse effects)
• Electroencephalography
• Epilepsy, Frontal Lobe (drug therapy)
• Female
• Follow-Up Studies
• Humans
• Male
• Nocturnal Paroxysmal Dystonia (chemically induced, diagnosis)
• Polysomnography
• Sleep Stages (drug effects)
• Sleep Wake Disorders (chemically induced, diagnosis)
• Young Adult