Activation of partial seizures with motor signs during cyclic alternating pattern in human sleep

Epilepsy Res. 1991 Nov-Dec;10(2-3):166-73. doi: 10.1016/0920-1211(91)90009-5.

Abstract

Both interictal and ictal EEG phenomena are commonly activated by functional instability. The different non-REM sleep stages comprise long-lasting periods of cyclic alternating pattern (CAP) in which arousal fluctuates between 'A phases' of greater arousal and 'B phases' of less arousal, and periods in which vigilance maintains a tonic stability (non-CAP). Previous studies have revealed that phase A induces a marked enhancement of generalized EEG paroxysms, a minor though significant activation of focal lesional bursts, but no effect on rolandic functional spikes. Conversely, phase B exerts an inhibitory modulation, especially on bilateral interictal phenomena. Because of the opposite influence of phase A and phase B also on muscle tone, we assessed the amount and distribution of nocturnal partial motor seizures in 6 subjects affected by focal epilepsy. The polysomnograms included 45 motor seizures, 43 of which occurred during non-REM sleep. Nocturnal fits were significantly more frequent in stages 1 and 3 (P less than 0.0001). Among the non-REM seizures, 42 appeared in CAP (P less than 0.0001) and always in phase A. The transient arousal and the concomitant muscle tone activation expressed by phase A of CAP is likely to support the motor components of nocturnal seizures. Sleep analysis in terms of CAP and non-CAP provides a better understanding of the continuum from subclinical EEG paroxysms to clinical manifestations and of the relations between vigilance and seizure disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Electroencephalography
  • Epilepsies, Partial / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Movement / physiology
  • Sleep Stages / physiology*