Effect of anticonvulsants on sleep.

The intensive study of seizures via serial 24-hour EEG-video monitoring has allowed enhanced observation of sleep patterns among epilepsy patients and has revealed that disturbed rest is common in this population. Previous work has shown that sleep deprivation of any type can exacerbate seizure activity, leading to speculation that the intrinsically poor sleep in these patients may serve as a threshold-lowering factor, and that this factor might be partially reversed by effective antiepileptic drugs (AEDs). However, to better understand this interaction, it is necessary to know whether the sleep disorder of epilepsy is caused by repetitive ictal events or whether it is part of a process that causes epilepsy to emerge in the first place.

Circadian rhythm, sleep, and epilepsy.

This review article: (1) describes the circadian distribution of ictal and interictal events; (2) differentiates transitional arousal, non-rapid eye movement and rapid eye movement sleep components and their substrates; (3) suggests the means by which the neural generators of these seizure-prone vs. seizure-resistant sleep and arousal states modulate the timing of different seizure manifestations; (4) considers clinical and mechanistic findings for the reciprocal effects of seizures and antiepileptic drugs upon the sleep-wake cycle; and (5) assesses clinical and basic mechanisms of sleep deprivation effects upon seizures.

Interictal spiking during wakefulness and sleep and the localization of foci in temporal lobe epilepsy.

We examined variations in interictal spiking during sleep and wakefulness to assess differences in reliability for localizing epileptic foci. Forty patients were studied prospectively. Spikes were assessed for rates, field, and appearance of new foci.