TY - JOUR
T1 - Is there a circadian variation of epileptiform abnormalities in idiopathic generalized epilepsy?
AU - Pavlova, Milena K.
AU - Shea, Steven A.
AU - Scheer, Frank A.J.L.
AU - Bromfield, Edward B.
N1 - Funding Information:
This study was partially supported by NIH Grants K24 HL076446 and T32 HL07901 . The laboratory protocol was performed at the General Clinical Research Center at the Brigham and Women’s Hospital. Equipment was loaned by Compumedix USA, Inc. Seizure and spike analysis software was provided by Persyst, Inc. Additional software support was given by Svetlin Abadjiev, Autopart.com., llc. Additionally, we thank Barbara A. Dworetzky, MD for help with recruitment of participants.
PY - 2009/11
Y1 - 2009/11
N2 - Epileptiform abnormalities often occur at specific times of day or night, possibly attributable to state of consciousness (sleep vs. wake) and/or influences from the endogenous circadian pacemaker. In this pilot study we tested for the existence of circadian variation of interictal epileptiform discharges (IEDs), independent of changes in state, environment, or behavior. Five patients with generalized epilepsy underwent a protocol whereby their sleep/wake schedule was evenly distributed across the circadian cycle while undergoing full-montage electroencephalography and hourly plasma melatonin measurements. Light was <8 lux to prevent circadian entrainment. All patients completed the protocol, testifying to its feasibility. All patients had normal circadian rhythmicity of plasma melatonin relative to their habitual sleep times. In the three patients with sufficient IEDs to assess variability, most IEDs occurred during non-rapid eye movement (NREM) sleep (ratio NREM:wake = 14:1, P < 0.001). In both patients who had NREM at all circadian phases, there was apparent circadian variation in IEDs but with different phases relative to peak melatonin.
AB - Epileptiform abnormalities often occur at specific times of day or night, possibly attributable to state of consciousness (sleep vs. wake) and/or influences from the endogenous circadian pacemaker. In this pilot study we tested for the existence of circadian variation of interictal epileptiform discharges (IEDs), independent of changes in state, environment, or behavior. Five patients with generalized epilepsy underwent a protocol whereby their sleep/wake schedule was evenly distributed across the circadian cycle while undergoing full-montage electroencephalography and hourly plasma melatonin measurements. Light was <8 lux to prevent circadian entrainment. All patients completed the protocol, testifying to its feasibility. All patients had normal circadian rhythmicity of plasma melatonin relative to their habitual sleep times. In the three patients with sufficient IEDs to assess variability, most IEDs occurred during non-rapid eye movement (NREM) sleep (ratio NREM:wake = 14:1, P < 0.001). In both patients who had NREM at all circadian phases, there was apparent circadian variation in IEDs but with different phases relative to peak melatonin.
KW - Circadian
KW - Epilepsy
KW - Idiopathic generalized epilepsy
KW - Interictal discharges
KW - Nocturnal
KW - Sleep
KW - Sleep/wake distribution
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U2 - 10.1016/j.yebeh.2009.08.022
DO - 10.1016/j.yebeh.2009.08.022
M3 - Article
C2 - 19786369
AN - SCOPUS:70350619351
SN - 1525-5050
VL - 16
SP - 461
EP - 467
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
IS - 3
ER -