OBJECTIVEMeasuring the serum concentrations of adrenocorticotropic hormone (ACTH) and cortisol in epileptic seizures during sleep to investigate their link to the EEG changes.

METHODSPre-surgical evaluation was performed by video-EEG monitoring using 24 channel recording. Thirty six epilepsy patients could be attributed to two groups: 28 patients had spontaneous seizures, and the other 8 patients whose seizures were induced by bemegride. Another 11 persons with confirmed psychogenic non-epileptic seizures (PNES) served as control group. Blood samples were obtained at five points: wake (08:00 a.m.), sleep (00:00 a.m.), and shortly before, during and after an epileptic seizure. The serum ACTH and cortisol were measured and analyzed by chemiluminescent immunoassay.

RESULTSThe levels of ACTH and cortisol in serum underwent significant changes: declining below the average sleep-level shortly before seizures, increasing during seizures, and far above the average wake-level after seizures (P < 0.001). Such changes did not occur in the control group (P > 0.05). The ACTH and cortisol levels had no significant difference between spontaneous group and bemegride-induced group (P > 0.05).

CONCLUSIONThe serum concentrations of ACTH and cortisol during sleep seizures are linked with pre-ictal and ictal EEG changes in epilepsy patients.

Action Potentials ; physiology ; Adolescent ; Adrenocorticotropic Hormone ; blood ; Adult ; Bemegride ; pharmacology ; Biomarkers ; blood ; Cerebral Cortex ; metabolism ; physiopathology ; Convulsants ; pharmacology ; Electroencephalography ; Epilepsy ; blood ; physiopathology ; Evoked Potentials ; physiology ; Humans ; Hydrocortisone ; blood ; Hypothalamo-Hypophyseal System ; metabolism ; physiopathology ; secretion ; Pituitary-Adrenal System ; metabolism ; physiopathology ; secretion ; Sleep Wake Disorders ; blood ; physiopathology ; Up-Regulation ; physiology ; Wakefulness ; physiology