Abstract
Study Objectives: The role of arousal from sleep in promoting epileptic seizures is controversial. To examine the question of whether seizures precede or follow arousals from sleep, we defined the timing of temporal lobe seizures in relation to sleep and arousal using combined scalp-intracranial electrodes. Design: Retrospective review of 67 sleep-related mesial temporal lobe seizures in 14 subjects. Setting: Inpatient epilepsy monitoring laboratory. Patients: Subjects with medically refractory mesial temporal lobe seizures undergoing epilepsy surgery evaluations. Interventions: None. Measurements and Results: Electroencephalographic (EEG) and/or polygraphic recordings and videotapes were independently reviewed to determine intracranial electrode seizure onset times and time of initial arousal from sleep. In 60 seizures in 13 subjects, intracranial ictal onsets always preceded clinical arousals from sleep. Electrographic signs of arousal in the scalp EEG, defined by the presence of sustained alpha or theta activity, either coincided with or followed, but never preceded, intracranial ictal onsets. In seven seizures in one subject with known seizures upon awakening, intracranial ictal onsets always followed clinical arousals and electrographic signs of arousal from sleep. Seven of the 14 subjects had electrooculogram and chin electromyogram monitoring; in these subjects, no seizures occurred during REM sleep with the majority occurring during NREM stage 2 sleep. Conclusions: Most sleep-related temporal lobe seizures occurred during NREM sleep and preceded arousals, supporting the premise that processes involved in the initiation and maintenance of NREM sleep play a greater role in facilitating temporal seizures than those involved in promoting REM sleep and arousal. However, arousal from sleep may provoke seizures in exceptional cases.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 231-234 |
| Number of pages | 4 |
| Journal | Sleep |
| Volume | 23 |
| Issue number | 2 |
| State | Published - Mar 15 2000 |
| Externally published | Yes |
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Keywords
- Arousal
- Epilepsy
- Epilepsy surgery
- Intracranial electrodes
- Non-rapid eye movement sleep
- Rapid eye movement sleep
- Seizures
- Sleep
ASJC Scopus subject areas
- Physiology
Cite this
Relationship of temporal lobe seizures to sleep and arousal : A combined scalp-intracranial electrode study. / Malow, Beth A.; Bowes, Robert J.; Ross, Donald (Don).
In: Sleep, Vol. 23, No. 2, 15.03.2000, p. 231-234.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Relationship of temporal lobe seizures to sleep and arousal
T2 - A combined scalp-intracranial electrode study
AU - Malow, Beth A.
AU - Bowes, Robert J.
AU - Ross, Donald (Don)
PY - 2000/3/15
Y1 - 2000/3/15
N2 - Study Objectives: The role of arousal from sleep in promoting epileptic seizures is controversial. To examine the question of whether seizures precede or follow arousals from sleep, we defined the timing of temporal lobe seizures in relation to sleep and arousal using combined scalp-intracranial electrodes. Design: Retrospective review of 67 sleep-related mesial temporal lobe seizures in 14 subjects. Setting: Inpatient epilepsy monitoring laboratory. Patients: Subjects with medically refractory mesial temporal lobe seizures undergoing epilepsy surgery evaluations. Interventions: None. Measurements and Results: Electroencephalographic (EEG) and/or polygraphic recordings and videotapes were independently reviewed to determine intracranial electrode seizure onset times and time of initial arousal from sleep. In 60 seizures in 13 subjects, intracranial ictal onsets always preceded clinical arousals from sleep. Electrographic signs of arousal in the scalp EEG, defined by the presence of sustained alpha or theta activity, either coincided with or followed, but never preceded, intracranial ictal onsets. In seven seizures in one subject with known seizures upon awakening, intracranial ictal onsets always followed clinical arousals and electrographic signs of arousal from sleep. Seven of the 14 subjects had electrooculogram and chin electromyogram monitoring; in these subjects, no seizures occurred during REM sleep with the majority occurring during NREM stage 2 sleep. Conclusions: Most sleep-related temporal lobe seizures occurred during NREM sleep and preceded arousals, supporting the premise that processes involved in the initiation and maintenance of NREM sleep play a greater role in facilitating temporal seizures than those involved in promoting REM sleep and arousal. However, arousal from sleep may provoke seizures in exceptional cases.
AB - Study Objectives: The role of arousal from sleep in promoting epileptic seizures is controversial. To examine the question of whether seizures precede or follow arousals from sleep, we defined the timing of temporal lobe seizures in relation to sleep and arousal using combined scalp-intracranial electrodes. Design: Retrospective review of 67 sleep-related mesial temporal lobe seizures in 14 subjects. Setting: Inpatient epilepsy monitoring laboratory. Patients: Subjects with medically refractory mesial temporal lobe seizures undergoing epilepsy surgery evaluations. Interventions: None. Measurements and Results: Electroencephalographic (EEG) and/or polygraphic recordings and videotapes were independently reviewed to determine intracranial electrode seizure onset times and time of initial arousal from sleep. In 60 seizures in 13 subjects, intracranial ictal onsets always preceded clinical arousals from sleep. Electrographic signs of arousal in the scalp EEG, defined by the presence of sustained alpha or theta activity, either coincided with or followed, but never preceded, intracranial ictal onsets. In seven seizures in one subject with known seizures upon awakening, intracranial ictal onsets always followed clinical arousals and electrographic signs of arousal from sleep. Seven of the 14 subjects had electrooculogram and chin electromyogram monitoring; in these subjects, no seizures occurred during REM sleep with the majority occurring during NREM stage 2 sleep. Conclusions: Most sleep-related temporal lobe seizures occurred during NREM sleep and preceded arousals, supporting the premise that processes involved in the initiation and maintenance of NREM sleep play a greater role in facilitating temporal seizures than those involved in promoting REM sleep and arousal. However, arousal from sleep may provoke seizures in exceptional cases.
KW - Arousal
KW - Epilepsy
KW - Epilepsy surgery
KW - Intracranial electrodes
KW - Non-rapid eye movement sleep
KW - Rapid eye movement sleep
KW - Seizures
KW - Sleep
UR - http://www.scopus.com/inward/record.url?scp=0034654187&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034654187&partnerID=8YFLogxK
M3 - Article
C2 - 10737340
AN - SCOPUS:0034654187
VL - 23
SP - 231
EP - 234
JO - Sleep
JF - Sleep
SN - 0161-8105
IS - 2
ER -