Distúrbios do sono na epilepsia do lobo temporal

Arquivos de Neuro-Psiquiatria (Impact Factor: 1.01). 01/2003; DOI: 10.1590/S0004-282X2003000600017
Source: DOAJ

ABSTRACT A presença de distúrbios do sono e macroestrutura do sono foi avaliada em 39 pacientes com epilepsia do lobo temporal (ELT). Sonolência foi a queixa mais frequente (85%), seguida por despertares noturnos (75%), história de crise epiléptica durante o sono (69%) e dificuldade de iniciar o sono (26%). As parassonias, síndrome de pernas inquietas, apnéia de sono e movimentos periódicos de membros inferiores foram os distúrbios de sono mais frequentes. Principais alterações da arquitetura de sono foram: fragmentação do sono, aumento do número de mudanças de estágios (100%) e do tempo acordado após o início do sono (77%) e redução do sono REM (92%). Houve correlação inversa entre a escala de sonolência de Epworth e o teste de latências múltiplas de sono (p < 0,05). Concluímos que pacientes com ELT apresentam um sono fragmentado, aumento do numero de mudanças de estágios, de despertares noturnos e do tempo acordado após o início do sono com redução do sono REM. Sonolência diurna foi uma das principais queixas dos pacientes com ELT.

Download full-text


Available from: Marcelo M Valença, Jul 01, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: The evidence for a mutual dependence between convulsive activity and duration of the paradoxical sleep (PS) can be found from the literature. Convulsions diminish the PS time, on the other hand, PS restriction increases the sensitivity to convulsion-inducing stimuli. In epilepsy, the operation of this positive feedback loop mechanism is possibly promoted by elevated levels of enkephalin and norepinephrine that are characteristic of epileptics. The above supports the convulsions-PS interplay representing a relevant therapeutic target in epilepsy. In this connection, usage of PS duration increasing hypnotics like thalidomide, in combination with enkephalin and norepinephrine antagonists is thought to be of special importance.
    Medical Hypotheses 07/2009; 73(4):608-9. DOI:10.1016/j.mehy.2008.10.040 · 1.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the study was to evaluate excessive daytime sleepiness and subjective sleep quality in patients who undergo epilepsy surgery for treatment of refractory partial seizures. Forty-eight patients were enrolled in this research study. All of them were evaluated 2 days before and 3 months after the surgery. Two questionnaires were used to assess daytime sleepiness (Epworth Sleepiness Scale [ESS]) and sleep quality (Pittsburgh Sleep Quality Index [PSQI]). Global PSQI was high (mean=5.65 SD=3.71) before the surgical procedure (P<0.001). PSQI evaluation revealed higher and statistically significant scores in three components as well as in the global score, when analyzed by predominance of daytime or nocturnal seizures. ESS and PSQI scores were also analyzed by gender, antiepileptic drug class, age, and seizure frequency, with no significant differences. We concluded that patients with partial recurrent seizures of temporal origin have poor subjective sleep quality that improves significantly after epilepsy surgery.
    Epilepsy & Behavior 12/2009; 17(1):120-3. DOI:10.1016/j.yebeh.2009.11.008 · 2.06 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: 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. 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 (24h/24). At each follow-up visit, interictal epileptiform abnormalities and sleep macrostructure parameters were assessed. 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. 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.
    Seizure 02/2012; 21(4):260-5. DOI:10.1016/j.seizure.2012.01.007 · 2.06 Impact Factor