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Sleep and temporal lobe epilepsy

A case study with depth electrodes

From Laboratoire d'étude du sommeil, Hôpital du Sacrè-Coeur, et Laboratoire d'étude de I'épilepsie, Hôpital Notre-Dame, Montréal, Québec. Canada.

We studied a patient with hippocampal epilepsy who had frequent nocturnal and diurnal seizures. Depth electrode recording showed that focal seizure discharges in the right hippocampus were of shorter duration in REM and non-REM sleep. However, awakening, especially from REM sleep or shortly after a REM period, facilitated the occurrence of a generalized seizure. There was no ultradian fluctuation in frequency or duration of seizure during diurnal recording. Night terrors (but not nightmares) disappeared after right temporal lobectomy, suggesting that pavor nocturnus was an ictal manifestation in this case.

Address correspondence and reprint requests to Dr. J. Montplaisir, Centre d'étude du sommeil, Hôpital du Sacré-Coeur, 5400 ouest, boul. Gouin. Montréal, Québec, Canada H4J 1C5.

Accepted for publication January 9, 1981.