Day/night patterns of focal seizures
Day/night patterns of focal seizures
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DOI：
10.1016/j.yebeh.2003.10.013
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发表时间：
2004-02-01
影响因子：
2.6
通讯作者：
Bromfield, EB
中科院分区：
文献类型：
--
作者：
Pavlova, MK;Shea, SA;Bromfield, EB
目的。在许多癫痫患者中，癫痫发作具有昼夜模式。我们的目的是比较不同致痫区域患者发作频率的昼夜模式。我们分析了15例颞叶癫痫(TLE)和11例颞叶外癫痫(XTLE)患者的视频脑电记录。每次发作根据受试者组(TLE与XTLE)、睡眠/觉醒状态和发作发生的时间(分成6 x 4小时“箱”)进行分类。在90例癫痫发作中，41例发生在TLE，49例发生在XTLE。各组癫痫发作均有昼夜模式，但组间模式不同。在癫痫发作中，50%的癫痫发作发生在15：00至19：00之间(每4个小时的“垃圾桶”中可能有17%的癫痫发作：F=3.59，P<；0.006)。XTLE在19：00~23：00之间有一个高峰(47%：F=4.72，P<；0.0018)。在有多个致痫区域的XTLE患者中，时间对癫痫发作的影响最不明显。TLE患者睡眠中癫痫发作的比例(19%)明显低于XTLE患者(41%)[P<；0.04，Fisher‘s Exact检验]。癫痫有明显的昼夜发作模式，但TLE和XTLE的发作模式有所不同。与睡眠/清醒状态有额外的相互作用，与XTLE相比，TLE从睡眠中发生的癫痫相对较少。因此，睡眠/清醒状态和昼夜或昼夜节律都可能影响癫痫发作倾向，不同的影响取决于致痫区域的位置。(C)2003年，爱思唯尔公司出版。
Purpose. In many patients with epilepsy seizures occur with a day/night pattern. Our aims were to compare day/night patterns in seizure frequency among patients with different epileptogenic regions.Methods. We analyzed video-EEG recordings in 15 patients with temporal lobe (TLE) and 11 with extratemporal lobe epilepsy (XTLE). Each seizure was classified according to subject group (TLE vs XTLE), sleep/wake state, and time of day of seizure occurrence (grouped into 6 x 4-hour "bins").Results. Of 90 seizures, 41 occurred in TLE and 49 in XTLE patients. There were day/night patterns of seizure occurrence in each group, with differences in the patterns between groups. In TLE, 50% of seizures occurred between the hours of 15:00 and 19:00 (17% would be expected by chance in each 4-hour "bin": F = 3.59, P < 0.006). In XTLE, there was a peak between 19:00 and 23:00 (47%: F = 4.72, P < 0.0018). The effect of time on seizures was least pronounced in the XTLE patients who had more than one epileptogenic region. The proportion of seizures occurring from sleep was significantly less in TLE (19%) than in XTLE patients (41%) [P < 0.04, Fisher's exact test].Conclusions. There are clear day/night patterns of seizure occurrence in epilepsy, with differences in the patterns between TLE and XTLE. There is an additional interaction with sleep/wake state, with relatively few seizures occurring from sleep in TLE compared with XTLE. Thus, it appears that both sleep/wake state and day/night or circadian rhythms may affect seizure proclivity, with different effects depending on the location of the epileptogenic region. (C) 2003 Published by Elsevier Inc.