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. 2022 Apr 26:16:849899.
doi: 10.3389/fnhum.2022.849899. eCollection 2022.

Sleep and Temporal Lobe Epilepsy - Associations, Mechanisms and Treatment Implications

Divyani Garg  1 , Laurel Charlesworth  2 , Garima Shukla  3
Affiliations

Sleep and Temporal Lobe Epilepsy - Associations, Mechanisms and Treatment Implications

Divyani Garg et al. Front Hum Neurosci. .

Abstract

In this systematic review, we aim to describe the association between temporal lobe epilepsy (TLE) and sleep, with bidirectional links in mechanisms and therapeutic aspects. Sleep stages may variably impact seizure occurrence, secondary generalization and the development, frequency and distribution of interictal epileptiform discharges. Conversely, epilepsy affects sleep micro- and macroarchitecture. TLE, the most frequent form of drug resistant epilepsy (DRE), shares an enduring relationship with sleep, with some intriguing potential mechanisms specific to anatomic localization, linking the two. Sleep characteristics of TLE may also inform localizing properties in persons with DRE, since seizures arising from the temporal lobe seem to be more common during wakefulness, compared to seizures of extratemporal origin. Polysomnographic studies indicate that persons with TLE may experience excessive daytime somnolence, disrupted sleep architecture, increased wake after sleep onset, frequent shifts in sleep stages, lower sleep efficiency, decreased rapid eye movement (REM) sleep, and possibly, increased incidence of sleep apnea. Limited literature suggests that effective epilepsy surgery may remedy many of these objective and subjective sleep-related concerns, via multipronged effects, apart from reduced seizure frequency. Additionally, sleep abnormalities also seem to influence memory, language and cognitive-executive function in both medically controlled and refractory TLE. Another aspect of the relationship pertains to anti-seizure medications (ASMs), which may contribute significantly to sleep characteristics and abnormalities in persons with TLE. Literature focused on specific aspects of TLE and sleep is limited, and heterogeneous. Future investigations are essential to understand the pathogenetic mechanisms linking sleep abnormalities on epilepsy outcomes in the important sub-population of TLE.

Keywords: Epworth sleepiness scale; cognition; mechanisms; polysomnography; refractory epilepsy; sleep; temporal lobe epilepsy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Summary diagram of associations, mechanisms and treatment implications of sleep and temporal lobe epilepsy.
FIGURE 2
FIGURE 2
PRISMA Flow diagram of included studies.
See this image and copyright information in PMC

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References

    1. Aboul Ezz H. S., Noor A. E., Mourad I. M., Fahmy H., Khadrawy Y. A. (2021). Neurochemical effects of sleep deprivation in the hippocampus of the pilocarpine-induced rat model of epilepsy. Iran J. Basic Med. Sci. 24 85–91. 10.22038/ijbms.2020.50621 - DOI - PMC - PubMed
    1. Badawy R. A. B., Harvey A. S., Macdonell R. A. L. (2009). Cortical hyperexcitability and epileptogenesis: understanding the mechanisms of epilepsy - part 1. J. Clin. Neurosci. 16 355–365. 10.1016/j.jocn.2008.08.026 - DOI - PubMed
    1. Bazil C. W., Walczak T. S. (1997). Effects of sleep and sleep stage on epileptic and nonepileptic seizures. Epilepsia 38 56–62. 10.1111/j.1528-1157.1997.tb01077.x - DOI - PubMed
    1. Bazil C. W., Castro L. H., Walczak T. S. (2000). Reduction of rapid eye movement sleep by diurnal and nocturnal seizures in temporal lobe epilepsy. Arch. Neurol. 57 363–368. 10.1001/archneur.57.3.363 - DOI - PubMed
    1. Beenhakker M. P., Huguenard J. R. (2009). Neurons that fire together also conspire together: is normal sleep circuitry hijacked to generate epilepsy? Neuron 62 612–632. 10.1016/j.neuron.2009.05.015 - DOI - PMC - PubMed

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