Ictal Phenomena During REM Sleep of a Temporal Lobe Epileptic

Abstract

EPSTEIN¹ described several modes of relationship existing between recurrent dreams and seizures in temporal lobe epileptics and suggested that such recurrent dreams are manifestations of cerebral pathophysiology. It would, therefore, be of value to investigate electroencephalographic patterns and dream content, during the dreaming sleep of certain temporal lobe epileptics. The work of Aserinsky and Kleitman² and Dement and Kleitman³ permits such an investigation by providing objective criteria of dream sleep: a low voltage relatively fast EEG pattern associated with rapid conjugate eye movements (REM sleep). Accordingly, the EEG and dream content of a patient with temporal lobe epilepsy and recurrent dreams were studied through two eight-hour sleep periods. The EEG findings in this patient were remarkable in that almost all dream periods were preceded by volleys of unilateral temporal spikes which then persisted in a characteristic rhythmic fashion through the dream (REM) period itself. Further, the