The relationship between sleep and epilepsy in frontal and temporal lobe epilepsies: Practical and physiopathologic considerations
The relationship between sleep and epilepsy in frontal and temporal lobe epilepsies: Practical and physiopathologic considerations
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DOI：
10.1111/j.1528-1157.1998.tb01352.x
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发表时间：
1998-02-01
期刊：
影响因子：
5.6
通讯作者：
Coubes, P
中科院分区：
文献类型：
--
作者：
Crespel, A;Baldy-Moulinier, M;Coubes, P
目的：方法：对30例难治性部分性癫痫患者，根据致痫灶的部位分为额叶癫痫（FLE）组和颞叶内侧癫痫（TLE）组，每组15例。在定义的抗癫痫药物（AED）、睡眠和睡眠剥夺方案下，通过连续5天的视频EEG监测来评估癫痫发作的频率和觉醒-睡眠分布。结果：两组患者在不同条件下癫痫发作的睡眠-觉醒分布及睡眠结构质量均有显著性差异。在FLE患者中，癫痫发作最常发生在睡眠期间，尽管睡眠组织正常。在TLE患者中，大多数癫痫发作发生在患者清醒时，并且睡眠组织的特征在于低效率指数。在所有研究条件下，FLE和TLE之间癫痫发作分布的差异持续存在，即，结论：睡眠记录可用于FLE的诊断，睡眠剥夺可用于TLE的监测，FLE的睡眠相关性发作可能依赖于额叶与丘脑皮层同步系统和清醒时乙酰胆碱调节系统的相互作用。
Purpose: The influence of sleep on the incidence of seizures and the reciprocal effects of epilepsy on sleep were analyzed in 30 patients with intractable partial seizures, all candidates fur surgery.Methods: The patients were classified into two groups of 15 patients according to the documented site of the epileptogenic zone: frontal lobe epilepsy (FLE) and medial temporal lobe epilepsy (TLE). Frequency and waking-sleep distribution of seizures were evaluated by continuous video-EEG monitoring for 5 days, under defined antiepileptic drug (AED), sleep, and sleep deprivation regimens. Sleep organization was analyzed by polysomnography prior to the presurgical protocol.Results: Significant differences were found between the two groups in sleeping-waking distribution of seizures under varied conditions, and in the quality of sleep organization. In FLE patients, seizures most often occurred during sleep, although sleep organization was normal. in TLE patients, most seizures occurred while patients were awake, and sleep organization was characterized by a low efficiency index. The difference in seizure distribution between FLE and TLE persisted under all conditions investigated, i,e., after AED discontinuation and sleep deprivation.Conclusions: Sleep recording may be useful for diagnosis of FLE, and monitoring after sleep deprivation for that of TLE, We speculate that sleep-related seizures in FLE may depend on Interaction between frontal lobe areas with the thalamus cortical synchronization system and the acetylcholine regulatory system of waking.