[West syndrome: a chronobiological approach]

Chronobiology is the discipline involving the study of the time structure of living creatures. Since it has been shown that there is non-chaotic recurrence, at precise intervals of time, of different functions from unicellular level to complex human systems, rhythmometric evaluation of key activities such as the activity-rest and sleeping-waking cycles appear to be useful non-invasive instruments for study of time structure in patients with episodic illness of the central nervous system (CNS) such as the epilepsies, in this case a serious variety of this disorder in childhood: West's syndrome.

We studied the activity-rest and sleep-waking cycles of two patients with West's syndrome and also their parents, using actometres (ZAK, made in Germany). At the same time the parents kept diaries (which they had previously been taught to do) at intervals of 20 minutes. They recorded the time of meals, administration of medicines, occurrence of seizures and data regarding the sleep of the patients. On subsequent analysis actograms were obtained. These are quantitative recordings of continuous motor activity.

A rhythm of a type lasting more than 24 hours was observed during the activity-rest and sleep-waking cycles in both patients, with predominance of seizures during the early hours of the day. There was also a high degree of synchronization in the mother-child interactions.

The presence of a rhythm of more than 24 hours in activity-rest and sleeping-waking shows the marked immaturity of the CNS in these patients, directly related to the severity of this type of epilepsy.