Modulation of Interictal Spikes by Sleep Structure in Complex Partial Seizure

ABSTRACT

We analyzed interictal spikes of complex partial seizure by two parameters of sleep structure. They are macrostrure and microstructure of sleep. The macrostructure of sleep is traditional parameter and includes REM and NREM sleep. The microstructure of sleep is recently identified modalities of arousal control during NREM sleep (a) the cyclic alternating pattern (CAP) expressed by alternating and successive phasic fluctuation of sleep; and (b) non-CAP(NCAP) characterized by prolonged stable periods of EEG. We performed polygraphical analysis of extended daytime-sleep of eight patients with complex partial seizure. The mean spike index(SI) was 4.9+3.6. The percentage of CAP time in total NREM was 50.7+5.8 and phase A in CAP time was 32.5+4.2. Significant increase in discharge rates was observed in NREM compared with REM sleep (pO. 05). Spiking activities were significantly enhanced during CAP sleep. Patients showed significant SI differences between CAP and NCAP sleep (psleep (p