OBJECTIVE To determine the relationship between seizure onset, sleep stage and focal cortical dysplasia type 2 (FCD2) location in sleep related epilepsy (SRE). METHODS We reviewed scalp video-EEG data of 77 patients with SRE among 130 surgically treated patients with histologically confirmed FCD2. Seizure onset was classified as occurring during NREM, REM and after arousal. RESULTS Sleep recordings were available for 65 patients (37 males, 7-49 years old). FCD2 was located in frontal lobe in 46 (71%) and in extra-frontal regions in 19, including the temporal lobe in 6. MRI was negative/doubtful in 35 cases. Interictal rhythmic/pseudorhythmic spike rate increased from 31% during waking to 65% during sleep. Seizure onset occurred from NREM in 46 cases (71%), mostly from stage 2, and after arousal in 14 (22%). Seizures occurring from NREM/REM sleep were significantly more frequent in frontal (89%) compared to extra-frontal location (42%), whilst arousal preceded seizure onset more often in extra-frontal (58%) compared to frontal location (7%). CONCLUSIONS NREM seizure onset is the most common ictal pattern in SRE due to frontal FCD2 whereas preceding arousal points to extra-frontal regions. SIGNIFICANCE Sleep recordings may help for FCD2 localisation and suggest topography dependent impact on sleep related epileptic networks.

中文翻译：

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2 型局灶性皮质发育不良中的睡眠相关癫痫：术前评估中睡眠记录的见解

目的 确定睡眠相关性癫痫 (SRE) 中癫痫发作、睡眠阶段和 2 型局灶性皮质发育不良 (FCD2) 位置之间的关系。方法 我们回顾了 130 名经手术治疗且组织学证实为 FCD2 的患者中 77 名 SRE 患者的头皮视频脑电图数据。癫痫发作被分类为发生在 NREM、REM 和觉醒后。结果 有 65 名患者（37 名男性，7-49 岁）的睡眠记录可用。FCD2 46 例（71%）位于额叶，19 例位于额外区，包括6 例颞叶。35 例MRI 阴性/可疑。发作间期节律性/假性节律性尖峰率从清醒时的 31% 增加到睡眠时的 65%。46 例 (71%) 的 NREM 发生癫痫发作，主要来自第 2 阶段，14 例 (22%) 在觉醒后发作。与额外位置 (42%) 相比，NREM/REM 睡眠引起的癫痫发作在额叶 (89%) 中发生的频率明显更高，而与额叶 (7%) 相比，在额外 (58%) 中觉醒更常发生在癫痫发作之前）。结论 NREM 发作是由于额叶 FCD2 导致的 SRE 中最常见的发作模式，而之前的觉醒指向额外区域。意义 睡眠记录可能有助于 FCD2 定位，并表明地形对睡眠相关癫痫网络的影响。结论 NREM 发作是由于额叶 FCD2 导致的 SRE 中最常见的发作模式，而之前的觉醒指向额外区域。意义 睡眠记录可能有助于 FCD2 定位，并表明地形对睡眠相关癫痫网络的影响。结论 NREM 癫痫发作是 SRE 中最常见的发作模式，因为额叶 FCD2 而之前的觉醒指向额外区域。意义 睡眠记录可能有助于 FCD2 定位，并表明地形对睡眠相关癫痫网络的影响。