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Sleep-wake distribution and circadian patterns of epileptic seizures in children
Esra Gurkas1, Ayse Serdaroglu2, Tugba Hirfanoglu2
1Department of Pediatric Neurology, Ankara Pediatric & Pediatric Hematology Oncology Training and Research Hospital, Dıskapı, Ankara 06110, Turkey.
Insights
Childhood epilepsy seizures show distinct daily and sleep-wake patterns. Seizure type and origin influence timing, aiding in understanding epilepsy chronobiology.
Area of Science:
- Neurology
- Chronobiology
- Epileptology
Background:
- Epilepsy is a prevalent chronic neurological disorder.
- The daily periodicity and diurnal patterns of epileptic seizures have been recognized for over a century.
Purpose of the Study:
- To investigate the circadian rhythms, including sleep/wake cycles and day/night distribution, of various seizure subtypes in children.
- To analyze the periodicity of seizure onset based on localization in pediatric epilepsy patients.
Main Methods:
- Analysis of 909 clinical seizures from 170 pediatric epilepsy patients undergoing video-electroencephalography (EEG) monitoring.
- Classification of seizure semiology and determination of seizure onset localization via EEG.
- Evaluation of seizure occurrence in relation to time of day (day/night), sleep/wake state, and specific 3-hour intervals over 24 hours.
Main Results:
- Specific seizure types exhibited distinct patterns: auras, dialeptic, myoclonic, hypomotor, atonic seizures, and epileptic spasms were more frequent during wakefulness and daytime.
- Tonic, clonic, and hypermotor seizures occurred more often during sleep and at night.
- Seizure onset localization correlated with timing: generalized seizures during wakeful afternoons, frontal lobe seizures at night/sleep, temporal lobe seizures during wakeful mornings/afternoons, occipital seizures during daytime wakefulness, and parietal seizures during daytime.
Conclusions:
- Epileptic seizures in children exhibit specific circadian patterns.
- The distribution of seizures across the sleep-wake cycle and time of day is dependent on seizure onset location and semiology.
Background:
Epilepsy is one of the most common chronic neurologic disorders. Daily periodicity of epileptic seizures has been known for over a century. The diurnal patterns of epileptic seizures have also been observed in studies.
Aim:
To investigate the sleep/wake cycle, day/night, and 24-h periodicity of various seizure subtypes and seizure onset localizations in children.
Methods:
We analyzed the clinical seizures of 170 consecutive epilepsy patients who underwent video-electroencephalography (EEG) monitoring over the last 5 years. Semiology of the seizures was classified according to the semiological seizure classification. Origin of the seizures was defined by the onset of ictal activity on EEG. Seizures were evaluated in terms of occurrence during the day (06:00-18:00 h) or night (18:00-06:00 h), in wakefulness or in sleep, and within a 3-h time interval throughout 24 h.
Results:
A total of 909 seizures were analyzed. Auras, dialeptic, myoclonic, hypomotor, atonic seizures, and epileptic spasms occurred more frequently in wakefulness; tonic, clonic, and hypermotor seizures occurred more frequently in sleep. Auras, dialeptic, and atonic seizures and epileptic spasms occurred more often during daytime; hypermotor seizures occurred more often at night. Generalized seizures were seen most frequently in wakefulness (between 12:00 and 18:00 h); frontal lobe seizures were seen at night and in sleep (between 24:00 and 03:00 h); temporal lobe seizures were seen in wakefulness (between 06:00 and 09:00 h and between 12:00 and 15:00 h); occipital seizures were seen during daytime and in wakefulness (between 09:00 and 12:00 h and between 15:00 and 18:00 h, respectively); parietal seizures were seen mostly during daytime.
Conclusions:
Seizures in children occur in specific circadian patterns and in specific sleep/wake distributions depending on seizure onset location and semiology.
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