The temporal relation between seizure onset and arousal-awakening in temporal lobe seizures

• Temporal lobe epilepsy patients showed that nocturnal seizures mostly followed arousal-awakening.
• The time interval between the seizure onsets and arousal-awakening related to these seizures was significantly shorter in patients with left-sided temporal lobe seizures.
• The arousal-awakening time before the right-sided seizures was longer than that before the left-sided seizures, either with or without propagation to the left.

PurposeOur main aim was to determine the time interval between the seizure onsets and arousal-awakening related to these seizures in patients with temporal lobe epilepsy (TLE) and to discuss the role of lateralization on arousal-awakening mechanisms.MethodsThirty-three TLE patients who underwent video-EEG monitoring with simultaneous polysomnography (PSG) and had recorded nocturnal seizures were retrospectively examined. These TLE patients had 64 seizures during sleep. The onsets of seizures and arousal-awakening related to these seizures were marked according to clinical and electrophysiological features. The time interval between the seizure onset and arousal-awakening related to the seizure was compared in patients with right- or left-sided temporal lobe seizures.ResultsIn our TLE patients nocturnal seizures mostly followed arousal-awakening (64%). The time interval between the seizure onset and arousal-awakening related to the seizure was significantly shorter in patients with left-sided temporal lobe seizures (p = 0.01).ConclusionVideo-EEG monitoring and PSG with scalp electrodes in our TLE patients showed that nocturnal seizures mostly followed arousal-awakening, and it was more pronounced in those with left-sided seizures. Arousal-awakening might be a signal for subsequent seizures in patients with TLE.