P52 – 2932: Sleep-wake distribution and circadian patterns of epileptic seizures in children

Abstract

Objective To investigate the sleep/wake cycle, day/night and 24-hour 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-year period. Semiology of the seizures was classified according to the semiological seizure classification. Origin of the seizures was defined by the onset of ictal activity in EEG. Seizures were evaluated in terms of occurence during the day (06:00–18:00) or night (18:00–06:00), in wakefulness or sleep and within the 3-hour time interval throughout 24 hours. Results A total of 909 seizures were analyzed. While auras, dialeptic, myoclonic, hypomotor, atonic seizures and epileptic spasms occurred more frequently in wakefulness; tonic, clonic, hypermotor seizures occurred more frequently in sleep. Auras, dialeptic, 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 12:00–18:00 h), frontal lob seizures were seen at night and in sleep (between 24:00–6:00 h), temporal lobe seizures were seen in wakefulness (between 06:00–09:00 h and 12:00 am-15:00 h), occipital seizures were seen during daytime and in wakefulness (between 09:00–12:00 h and 15:00–18:00 h), parietal seizures were seen mostly during daytime. Conclusion Seizures in children occur in specific circadian patterns and in specific sleep/wake distributions depending on seizure onset location and semiology. Recognition of these daily patterns of seizures provides new diagnostic and therapeutic options. To investigate the sleep/wake cycle, day/night and 24-hour periodicity of various seizure subtypes and seizure onset localizations in children. We analyzed the clinical seizures of 170 consecutive epilepsy patients who underwent video-electroencephalography (EEG) monitoring over the last 5-year period. Semiology of the seizures was classified according to the semiological seizure classification. Origin of the seizures was defined by the onset of ictal activity in EEG. Seizures were evaluated in terms of occurence during the day (06:00–18:00) or night (18:00–06:00), in wakefulness or sleep and within the 3-hour time interval throughout 24 hours. A total of 909 seizures were analyzed. While auras, dialeptic, myoclonic, hypomotor, atonic seizures and epileptic spasms occurred more frequently in wakefulness; tonic, clonic, hypermotor seizures occurred more frequently in sleep. Auras, dialeptic, 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 12:00–18:00 h), frontal lob seizures were seen at night and in sleep (between 24:00–6:00 h), temporal lobe seizures were seen in wakefulness (between 06:00–09:00 h and 12:00 am-15:00 h), occipital seizures were seen during daytime and in wakefulness (between 09:00–12:00 h and 15:00–18:00 h), parietal seizures were seen mostly during daytime. Seizures in children occur in specific circadian patterns and in specific sleep/wake distributions depending on seizure onset location and semiology. Recognition of these daily patterns of seizures provides new diagnostic and therapeutic options.