Diurnal rhythms in seizures detected by intracranial electrocorticographic monitoring: An observational study

Hofstra, Wytske A.; Spetgens, Willy P.J.; Leijten, Frans S.S.; Rijen, Peter C. van; Gosselaar, Peter H.; Palen, Job van der; Weerd, A.W. de

doi:10.1016/j.yebeh.2009.01.020

Cited by 67 publications

(57 citation statements)

References 18 publications

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“…In a previous study, we recorded 450 seizures detected by intracranial electroencephalography (EEG). The seizures showed an uneven distribution over the day, depending on the lobe of origin; temporal lobe seizures occurred preferentially between 11:00 and 17:00 h, frontal seizures between 23:00 and 05:00 h, and parietal seizures between 17:00 and 23:00 h (Hofstra et al, 2009b). Other studies showed roughly similar time peaks in temporal and frontal seizures (Durazzo et al, 2008;Hofstra et al, 2009a;Pavlova et al, 2004;Quigg et al, 1998).…”

Section: Discussionmentioning

confidence: 77%

“…Circadian rhythms in several physiological functions, such as heart rate variability, have been shown to be changed in epileptics (for review, see Hofstra & de Weerd, 2009). Also, several human studies have shown diurnal rhythmicity in seizure occurrence (Durazzo et al, 2008;Hofstra et al, 2009aHofstra et al, , 2009bPavlova et al, 2004;Quigg et al, 1998). Unfortunately, none of these studies have taken circadian rhythmicity into account.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have focused on diurnal rhythmicity in epilepsy. For example, it appears that human seizure occurrence may have 24-h rhythmicity, depending on the origin of seizures (Durazzo et al, 2008;Hofstra et al, 2009aHofstra et al, , 2009bPavlova et al, 2004;Quigg et al, 1998). However, there is also accumulating evidence that circadian rhythms may also play a role in epilepsy (Hofstra & de Weerd, 2009;Pavlova et al, 2009;Quigg et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Chronotypes and Subjective Sleep Parameters in Epilepsy Patients: A Large Questionnaire Study

Hofstra¹,

Gordijn²,

Poel³

et al. 2010

Chronobiology International

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Accumulating evidence suggests epilepsy and seizures may influence circadian rhythms and that circadian rhythms may influence epilepsy. It is also conceivable that seizure timing influences the timing of daily activities, sleeping, and wakefulness (i.e., chronotype). Only one group has studied the distribution of chronotypes of epileptics, showing significant differences between the diurnal activity patterns in two groups of patients with different epilepsy syndromes. The authors performed a questionnaire-based study of 200 epilepsy patients to compare the distribution of chronotypes and subjective sleep parameters of sleep duration and time of mid-sleep on free days to the distribution in the general population (n = 4042). Within this large group of epilepsy patients, we also compared the chronotypes of subsamples with well-defined epilepsy syndromes, i.e., temporal lobe epilepsy [TLE; n = 46], frontal lobe epilepsy [FLE; n = 30], and juvenile myoclonic epilepsy [JME; n = 38]. In addition, 27 patients who had had surgery for TLE were compared with those with TLE who had not had surgery. Both the Morningness-Eveningness Questionnaire and Munich Chronotype Questionnaire were used to determine chronotypes and subjective sleep parameters. Significant differences in morningness/eveningness distribution, timing of mid-sleep (corrected for sleep duration), and total sleep time on free days were found between epileptics and healthy controls. Those with epilepsy were more morning oriented, had earlier mid-sleep on free days, and longer sleep duration on free days (p < .001). However, distributions of chronotypes and sleep parameters between the groups of people with TLE, FLE, and JME did not differ. Persons who had surgery for TLE had similar morningness-eveningness parameters and similar sleep durations compared to those without surgery, but mid-sleep on free days was earlier in operated patients (p = .039). In conclusion, this is the first large study focusing on chronotypes in people with epilepsy. We show that the distribution of chronotypes and subjective sleep parameters of epileptics, in general, is different from that of healthy controls. Nevertheless, no differences are observed between patients with specified epilepsy syndromes, although they exhibit seizures with different diurnal patterns. Our results suggest that epilepsy, itself, rather than seizure timing, has a significant influence on chronotype behavior and subjective sleep parameters.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronotypes and Subjective Sleep Parameters in Epilepsy Patients: A Large Questionnaire Study

Hofstra¹,

Gordijn²,

Poel³

et al. 2010

Chronobiology International

Self Cite

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“…Hofstra et al [16,26] reported that more seizures were observed from 11:00 to 17:00, and fewer seizures from 23:00 to 05:00. They suggested that certain types of seizures have a strong tendency to occur in a truly diurnal pattern.…”

Section: Discussionmentioning

confidence: 99%

“…We used two methods to evaluate the diurnal distribution. First, we adopted a method that was used in a previous study [16]. The 24-h day was divided into four bins.…”

Section: Data Acquisition and Analysismentioning

confidence: 99%

Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

Dhuha

Konno

Yokota

et al. 2017

E&S

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Purpose:The pur pose of this study was to deter mine the optimal dur ation of long-term video-EEG monitoring (VEEG) in patients with epilepsy. The response time of medical staff to seizures was also evaluated from the viewpoint of safety of the monitoring. Methods: We estimated the optimal duration of VEEG from the seizure onset pattern. We retrospectively investigated all VEEG sessions performed in our department during the period between June 2005 and July 2016. Sessions with no seizures and with only non-epileptic seizures were excluded. Using 91 sessions from 69 patients, information on the onset time and response time of medical staff to seizures was collected. Results: The median duration from the start of VEEG to the first seizure was 2 days. Seventy-seven percent of first seizures occurred within 3 days of VEEG. The median duration from the first seizure to the third seizure was 2 days. Eighty percent of third seizures occurred within 3 days of the first seizure. There was no significant diurnal distribution of seizure occurrence. Medical staff did not respond to 20% of generalized seizures and 69% of focal seizures. The overlooking of generalized seizures occurred mainly during the hours of 1-2 pm and 8-9 pm but there was no significant diurnal pattern in overlooking generalized and focal seizures.Conclusion：Based on these findings, we suggest that VEEG can be terminated when no seizure occurs within 4 days after onset. In our VEEG protocol, in which all antiepileptic drugs were discontinued before the start of a session, there was no diurnal pattern of seizure occurrence. This is the first study investigating the diurnal pattern of overlooking seizures by medical staff during VEEG. Since there was no diurnal pattern to the overlooking, medical staff should pay equal, 24-hour attention to patients on VEEG.

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Clinical trials for Lennox–Gastaut syndrome: Challenges and priorities

Knowles,

Warren,

Mohamed

et al. 2024

Ann Clin Transl Neurol

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Objective: Lennox‐Gastaut syndrome (LGS) is a severe, childhood‐onset epilepsy that is typically refractory to treatment. We surveyed the current landscape of LGS treatment, aiming to identify challenges to the development of efficacious therapies, and to articulate corresponding priorities toward clinical trials that improve outcomes. Methods: The LGS Special Interest Group of the Pediatric Epilepsy Research Consortium integrated evidence from the literature and expert opinion, into a narrative review. Results: We provide an overview of approved and emerging medical, dietary, surgical and neuromodulation approaches for LGS. We note that quality of care could be improved by standardizing LGS treatment based on expert consensus and empirical data. Whereas LGS natural history is incompletely understood, prospective studies and use of large retrospective datasets to understand LGS across the lifespan would enable clinical trials that address these dynamics. Recent discoveries related to LGS pathophysiology should enable development of disease‐modifying therapies, which are currently lacking. Finally, clinical trials have focused chiefly on seizures involving “drops,” but should incorporate additional patient‐centered outcomes, using emerging measures adapted to people with LGS. Interpretation: Clinicians and researchers should enact these priorities, with the goal of patient‐centered clinical trials that are tailored to LGS pathophysiology and natural history.

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Diurnal rhythms in seizures detected by intracranial electrocorticographic monitoring: An observational study

Cited by 67 publications

References 18 publications

Chronotypes and Subjective Sleep Parameters in Epilepsy Patients: A Large Questionnaire Study

Chronotypes and Subjective Sleep Parameters in Epilepsy Patients: A Large Questionnaire Study

Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

Clinical trials for Lennox–Gastaut syndrome: Challenges and priorities

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