Sleep and temporal lobe epilepsy: a case study with depth electrodes

We studied a patient with hippocampal epilepsy who had frequent nocturnal and diurnal seizures. Depth electrode recording showed that focal seizure discharges in the right hippocampus were of shorter duration in REM and non-REM sleep. However, awakening, especially from REM sleep or shortly after a REM period, facilitated the occurrence of a generalized seizure. There was no ultradian fluctuation in frequency or duration of seizure during diurnal recording. Night terrors (but not nightmares) disappeared after right temporal lobectomy, suggesting that pavor nocturnus was an ictal manifestation in this case.