Eventi minori in sonno nelle epilessie temporali

Introduction: "Minor Motor Events" (MMEs) in sleep have been well described in Nocturnal Frontal Lobe Epilepsy (NFLE). Yet there are no evidences of minor events in sleep in other forms of partial epilepsies, such as "Nocturnal Temporal Lobe Epilepsy (NTLE). The aim of our study was to evaluate a sample of NTLE patients to verify the existence of "minor events" in sleep and to define the clinical features and their possible EEG correlation. Material and methods: we evaluated 15 patients (9 F, 6 M, mean age 28.3 ± 16.7, range: 5-65) diagnosed as TLE sindrome (ILAE criteria, 1989) who complained a disturbed nocturnal sleep. All of them underwent EEG in wakefulness, brain MRI and Video-polisomnographic recording (PSG). After a careful review of the video, every movement in sleep was analyzed. Referring to the criteria of MMEs of NFLE, the motor pattern of short duration, with or without electrical correlation was selected and defined "Minor Event" (ME). When a motor pattern was without EEG correlation, it was defined ME if it was similar to a part of a clear seizure, too. Results: Analysis of Video-PGS has shown that MEs are present in NTLE. Unlike MMEs described in NFLE, their number per night is lower, have a longer duration and a lower speed of action. In family and personal history of patients, association with parasonnias (6.7%) is not important compared to the values found in NFLE. The stage N2 and the kappa-complex appear to be the trigger points. Unlike the NFLE, in our patients an electrical correlation is more often present (87%), ranging from a short desynchronization to a clear pattern of ictal activity. The lack of synchronization between the clinical event and the electrical correlation could be a peculiarity for MEs in NTLE.