| Objective: To study the characteristics and analyze the correlation of the sleep disorder in patients with temporal lobe epilepsy(TLE) using polysomnography and clinical scale evaluation.Methods: 1. In the period between January 2015 to August 2015, 21 patients with temporal lobe epilepsy at the outpatient clinic of General hospital of tianjin medical university were recruited as the group of temporal lobe epilepsy, at the same time 18 cases of healthy volunteers were recruited as the controls.The patients who had been diagnosed with epilepsy(temporal lobe epilepsy) were in accordance with the criteria of the International League Against Epilepsy.2.Taking the history, patients with temporal lobe epilepsy keep recording epilepsy diary for at least 4 weeks of and sleep diaries 2 weeks. While healthy volunteers keep recording sleep diaries 2 weeks. Patients with temporal lobe epilepsy were without seizures 48 hours before the day went on polysomnography.3.All the 21 patients with temporal lobe epilepsy and 18 cases of healthy controls completed a self-administered questionnaire, including the Pittsburgh sleep quality index scale(PSQI), the Epworth sleepiness scale(ESS), depression self rating scale(BDI- II), the evaluation of fatigue scale(FS- 14) scale, before the day went on polysomnography, then analyzed the scores of these scales.4. 21 patients with temporal lobe epilepsy and 18 cases of healthy controls were went on polysomnography. All recordings were visually analyzed by two independent observers, and the following information was collected: sleep structure parameters, respiratory events, body movements, and percutaneous oxygen saturation etc.5. The characteristics of sleep disorder of patients with temporal lobe epilepsy and the correlation between clinical symptoms and clinical rating scale was analyzed.Results: 1. The assessment of clinical rating scale suggests that depression scores of temporal lobe epilepsy was significantly higher than the controls [(8.57-2.66) vs(2.72-1.48), t= 8.24, P < 0.05]. Compared with the controls, the fatigue points of temporal lobe epilepsy is higher [(6.43 + 3.52), vs(2.67-1.08), t =,4.36, P < 0.05)].2. Wake after sleep onset is significantly prolonged in patients with temporal lobe epilepsy than the controls [(53.40 + 16.62) min vs(41.11 + 7.41) min, t = 2.89, P <0.05)]. The total sleep stage shifts, sleep stage shifts per an hour and the sleep stage N2 shifts in patients with temporal lobe epilepsy are higher than the controls [(131.38±31.95),(20.16 + 6.22),(48.76 + 10.62) times vs(110.39 + 25.29),(16.52-3.81),(39.78-11.84) times, t = 2.45, 2.16, 2.49, P < 0.05]. Compared to the controls, patients with temporal lobe epilepsy had prominent increases in periodic limb movement(PLM)index and PLM in REM stage[(1.74 + 2.37),(1.53 + 1.99) times/h vs(0.37 + 0.68),(0.01-0.04) times/h, t = 1.89, 2.57, P < 0.05].3. Sleepiness is correlated with fatigue(r = 0.542, P = 0.542), but is not associated with depression(r = 0.262, P = 0.262) and sleep quality(r = 0.077, P = 0.077). Sleepiness is related with number of antiepileptic drugs(r = 0.478, P = 0.478), but is not associated with the duration(r = 0.184, P = 0.184) and seizure frequency(r = 0.379, P = 0.379). Wake after sleep onset is correlated with duration(r = 0.506, P = 0.506), but is not associated with seizure frequency(r = 0.051, P = 0.051). Wake after sleep onset is correlated with depression(r = 0.596, P = 0.596), but is not associated with fatigue(r = 0.040, P = 0.040). Number sleep stage shifts per an hour is correlated with depression(r = 0.461, P = 0.461), but is not associated with fatigue rating(r = 0.118, P = 0.118).Conclusion 1. Patients with temporal lobe epilepsy sleep disorder, including wake after sleep onset prolonged, the total sleep shifts and sleep stage shifts per an hour increased,periodic limb movements. 2. Sleep disorders in patients with temporal lobe epilepsy and epilepsy is negatively related to the length of the course of the disease. 3. Sleep disorders in patients with temporal lobe epilepsy and epilepsy is related to depression. 4. Sleep disorders in patients with temporal lobe epilepsy and epilepsy is not associated with fatigue and the frequency of seizures. |
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