Gabapentin-induced modulation of interictal epileptiform activity related to different vigilance levels

Objectives: Gabapentin (GBP) is a novel antiepileptic drug (AED), currently used as add-on therapy in patients with partial seizures. Similar to other AEDs, little is known about its effects on nocturnal sleep, despite the st rict relationship between sleep and epileptic discharges. The aim of our st udy was to evaluate the effects of chronic therapy with GBP on both nocturn al sleep and on interictal epileptiform abnormalities (IEA) in relation to the different sleep stages. Methods: Eighteen patients affected by partial seizures resistant to common AEDs were submitted to nocturnal polygraphic recordings under baseline con ditions and after 4 months of add-on GBP treatment. Results: We observed a significant increase in unilateral/focal IEA during light NREM sleep and a significant reduction in bilateral/diffuse IEA durin g wakefulness after sleep onset (WASO) with respect to the baseline conditi on. A significant increase in REM sleep and slow wave sleep (SWS) associate d with a reduction in the number of awakenings and Stage 1 was also observe d after GBP chronic therapy. Conclusions: GBP therapy improves the sleep pattern of epileptic patients a nd it seems to modulate the expression of IEA with different effects in rel ation to the various vigilance levels. (C) 2000 Elsevier Science Ireland Lt d. All rights reserved.