Daily rhythms in right-sided and left-sided temporal lobe epilepsy

LATINI FACUNDO; SILVIA ODDO; ANZULOVICH A; KOCHEN SILVIA

BMJ Neurology Open

BMJ journals

Lugar: London; Año: 2023 vol. 4 p. 1 - 9

2632-6140

Introduction Epilepsy is closely related to daily rhythms,such as the sleep–wake cycle. The objective of this studywas to evaluate the relationship between drug-resistanttemporal lobe epilepsy (TLE) and the parameters related tothe sleep–wake cycle, seizure time and epilepsy laterality.Methods Consecutive patients admitted to the videoelectroencephalogram unit with a diagnosis of TLE wereenrolled. Patients were divided into two groups: thosewith left TLE (LTLE) and those with right TLE (RTLE). Theythen remained in the conditions of 12-hour light, 12-hourdarkness. Demographic data, treatment, number andtime of seizure occurrence, sleep diary, morningness–eveningness questionnaire, Pittsburgh Sleep Quality Indexand Epworth Sleepiness Scale were recorded.Results In total, 74 patients with TLE, 43 with LTLE and31 with RTLE, were studied. RTLE patients showed asignificant preference for morningness. Patients treatedwith benzodiazepines showed worse sleep quality andgreater daytime sleepiness. Patients who did not reportany clear predominance and patients who reportedseizures during wakefulness had significantly moreseizures during wakefulness and patients who reportedsleep predominance had more seizures during sleep(p>0.001). The LTLE group had a greater number ofseizures from 8 to 16 hours, unlike the RTLE group, whichhad a uniform distribution (p=0.008).Conclusions This was a prospective study of patientswith drug-resistant TLE performed in a controlledenvironment to study the impact of daily rhythms, seizurefrequency and seizure distribution. Laterality seems to be akey factor in seizure distribution.