The Difference From Rapid Eye Movement Sleep Behavior Disorder To Frontal Lobe Epilepsy And Analysis Of The Effects Of Both On Sleep Parameters

Objective:The main purpose of this study is to ascertain the differential diagnoses of episodes during sleep,mainly through a method based on night recording mode,combined with video electroencephalography(EEG)and polysomnography(PSG).Mainly identify frontal lobe epilepsy(FLE)and sleep REM sleep behavior disorder(RBD),and analysis their effects on sleep parameters.Method:From June 2018 to December 2019,the clinical data including the normal control group,the patients with frontal lobe epilepsy or RBD were collected from the Neurology sleep center of the first hospital Jilin University.analyzed the clinical general data,24hEEG and PSG.Compared the sleep parameters in 3 groups.Results:The results showed that there was a significant difference at onset age between patients with RBD and frontal lobe epilepsy(X~2=2.281,P=0.033).We analysis the clinical characteristics of RBD and Frontal lobe epilepsy,which showed as followings:RBD group:Shouting and hitting related to the dream during REM sleep(3 cases);paroxysmal limb movement(9cases)and shaking arm(8 cases),Paroxysmal limb weakness and speaking slurred(7 cases),which happened in REM stage;Epilepsy group:Sitting up in bed following by staring(5 cases),Losing consciousness twice(12 cases)Paroxysmal tic(12 cases)which happened in NREM stage 2.Compared and analyzed the electric physiological data of both groups,we can find that there are more epileptic waves in FLE patients,and RSWA in RBD patients(P<0.05),1 patient is a case of epilepsy comorbidity.Compared with the sleep parameters of the control group(normal)and the sleep behavior disorder group(RBD and Epilepsy),which showed that there were significant difference in SE(P<0.05),WASO(P<0.05),REM%,N1(P<0.05),and arousal index(P<0.001),and there were significant difference in AHI(P<0.010)and PLM index(P<0.010).The value of Arousal and N1 in RBD group are higher than that in FLE group,the indexes of AHI and PLMI are higher in RBD group than that in FLE group(P<0.05).Conclusions:The study will facilitate to distinguish from RBD to frontal lobe epilepsy through the combination of clinical features and the application of all night(video PSG and EEG).Both RBD and FLE decreased the sleep quality.The effects of RBD on sleep structure is more serious than that of FLE,and RBD are often happened with apnea and PLMD.