[Organization of sleep in recent temporal lobe epilepsy before and after treatment with carbamazepine]

Sleep in epileptic patients with complex partial seizures has been considered as being less well organized than in normal subjects. This study attempted to precise whether this disorganization could be related to the length of the disease and could be improved by carbamazepine treatment. The study was performed in 15 patients with recently diagnosed (less than 3 months) and untreated temporal lobe epilepsy. Neurologic examination and CT scan were normal. Patients did not present a generalized seizure in the preceding 48 hours and during the study. Nocturnal sleep polygraphic recordings were performed: 2 recordings before treatment and 2 others after one month of carbamazepine administration (800 mg/day). Before treatment sleep was characterized by a marked instability (increase in awakenings, shifts in sleep stages, waking after sleep onset, stage 1 duration) when compared to normal subjects. Carbamazepine treatment improved sleep stability. Our data support the hypothesis of another possible mechanism than the occurrence of seizures to explain the disorganization of sleep in temporal lobe epilepsy. On the other hand sleep instability could not be related to the length of the disease since it existed soon after its onset. Carbamazepine treatment improved sleep stability and this improvement could play a role in the therapeutic effect of the drug.