Are behavioral disorder and sleep disruption in complex partial seizures related?

Abstract

We tested the hypothesis that interictal behavior disorder and sleep disruption in complex partial seizures share a common pathogenesis. Twelve adult male patients with complex partial seizures were studied using polysomnographic and neuropsychological techniques. Sleep abnormalities were shown by impaired sleep efficiency (<85%, 4 patients), excessive percentage of Stage I sleep (> 15%, 8 patients), prolonged sleep onset latency (>25 min, 6 patients), and impaired four-nap Multiple Sleep Latency Test (<10 min, 5 patients). Neuropsychological testing revealed high Bear-Fedio inventory scores in eight patients, high Minnesota Multiphasic Personality Inventory (MMPI) scores on scales 1–3 and 7–8 in half or more patients, and impairment ratings 2 or worse on Trails A and B, Warrington-Word and Warrington-Face Recognition, and Boston Naming in one-third to two-thirds of all patients. Multiple regression analyses suggested high correlation between neuropsychological and sleep variables (multiple R for MMPI-3, MMPI-5, Bear-Fedio, Warrington-Word, Warrington-Face, Boston Naming, and Trails A versus sleep variables being 0.81, 0.75, 0.77, 0.71, 0.68, 0.58, and 0.63, respectively). These findings were not merely a function of demographic/clinical variables, since most neuropsychological variables did not correlate with the former (adjusted R 2 < 0.2; p > 0.5). These preliminary data lend support to the common pathogenesis of sleep and behavioral disorder in patients with complex partial seizures.