Patients with intractable epilepsy have low melatonin, which increases following seizures

Abstract

Melatonin, which is used to treat sleep disorders, has anticonvulsant properties. The authors measured salivary melatonin and cortisol, at baseline and following seizures, in patients with intractable temporal lobe epilepsy and controls. Melatonin was reduced in patients with epilepsy at baseline compared with controls, and increased threefold following seizures. Cortisol also increased following seizures. Patients with intractable epilepsy have low baseline melatonin levels that increase dramatically following seizures.

Figure 1

Melatonin levels in a patient with temporal lobe epilepsy, under baseline and seizure conditions. The patient is a 26-year-old woman; a secondarily generalized seizure occurred at 16:25 and lasted 4 minutes and 16 seconds. A control patient, a 45-year-old woman with vertigo, shown for comparison, manifests a normal diurnal pattern.

Figure 2

Melatonin levels (area under the saliva concentration-time curve for 24 hours) in patients with temporal lobe epilepsy under baseline and seizure conditions, compared with control patients. Data are shown for all seizures, and for only patients with secondarily generalized seizures. Light gray bars = baseline; dark gray bars = seizure; black bars = controls. Asterisks indicate p < 0.05 compared with patient baseline; diamonds indicate p < 0.05 compared with control patients.

Figure 3

Cortisol levels (area under the saliva concentration-time curve for 24 hours) in patients with temporal lobe epilepsy under baseline and seizure conditions, compared with control patients. Data are shown for all seizures, and for only patients with secondarily generalized seizures. Light gray bars = baseline; gray bars = seizure; black bars = control. Asterisks indicate p < 0.05 compared with patient baseline.