Clinical, polysomnographic and computerized electroencephalographic research in temporal lobe epilepsies.

Abstract

The present study has selected 125 cases with psychomotor attacks (sometimes secondarily generalized). Polysomnographic recordings were carried out for a continuous period of eight hours. All this time, the patients have been observed by video-monitorization on a closed infrared circuit screen. The diagnostic procedure was supported by several computerized EEG mappings (CEM) according to a model achieved by us, transcribing the primary data which were obtained by Hjorth's NSD parameters (activity and ability) from the Siemens-Elema Mingograph to a microcomputer. In many cases, we have employed an interface which had been envisaged by us for analog-digital conversion of amplitudes and frequencies from the Mingograph to the microcomputer. Sleep organization anomalies were found: increase of the percentages of light slow-wave sleep (LSWS) and of REM sleep and reduction of the percentages of deep slow-wave sleep (DSWS). The temporal foci appeared with the greatest frequency and with a clear-cut evidence during LSWS, especially in REM sleep and in the transitional states of SWS to REM sleep and from REM sleep to wakefulness. Our researches supplemented with CEM, demonstrate a peculiar activation of the temporal foci during REM sleep, during the states of LSWS and during the transitional states, showing that many psychomotor attacks appear predominantly during these sleep states and that many cases initially clinically misinterpreted as grand mal seizures are, in fact, focal temporal epilepsies secondarily generalized.