TY - JOUR
T1 - The onset of pediatric refractory status epilepticus is not distributed uniformly during the day
AU - Sánchez Fernández, Iván
AU - Gaínza-Lein, Marina
AU - Abend, Nicholas S.
AU - Amengual-Gual, Marta
AU - Anderson, Anne
AU - Arya, Ravindra
AU - Brenton, J. Nicholas
AU - Carpenter, Jessica L.
AU - Chapman, Kevin E.
AU - Clark, Justice
AU - Farias-Moeller, Raquel
AU - Davis Gaillard, William
AU - Glauser, Tracy A.
AU - Goldstein, Joshua
AU - Goodkin, Howard P.
AU - Guerriero, Réjean M.
AU - Hecox, Kurt
AU - Jackson, Michele
AU - Kapur, Kush
AU - Kelley, Sarah A.
AU - Kossoff, Eric H.W.
AU - Lai, Yi Chen
AU - McDonough, Tiffani L.
AU - Mikati, Mohamad A.
AU - Morgan, Lindsey A.
AU - Novotny, Edward J.
AU - Ostendorf, Adam P.
AU - Payne, Eric T.
AU - Peariso, Katrina
AU - Piantino, Juan
AU - Riviello, James J.
AU - Sannagowdara, Kumar
AU - Stafstrom, Carl E.
AU - Tasker, Robert C.
AU - Tchapyjnikov, Dmitry
AU - Topjian, Alexis A.
AU - Vasquez, Alejandra
AU - Wainwright, Mark S.
AU - Wilfong, Angus
AU - Williams, Korwyn
AU - Loddenkemper, Tobias
N1 - Funding Information:
This study and consortium was funded by the Epilepsy Foundation of America ( EF-213583 , Targeted Initiative for Health Outcomes), by American Epilepsy Society/Epilepsy Foundation of America Infrastructure Awards , the Pediatric Epilepsy Research Foundation , and the Epilepsy Research Fund .
Publisher Copyright:
© 2019 British Epilepsy Association
PY - 2019/8
Y1 - 2019/8
N2 - Purpose: To evaluate whether the onset of pediatric refractory status epilepticus (rSE) is related to time of day. Method: We analyzed the time of day for the onset of rSE in this prospective observational study performed from June 2011 to May 2019 in pediatric patients (1 month to 21 years of age). We evaluated the temporal distribution of pediatric rSE utilizing a cosinor analysis. We calculated the midline estimating statistic of rhythm (MESOR) and amplitude. MESOR is the estimated mean number of rSE episodes per hour if they were evenly distributed. Amplitude is the difference between MESOR and maximum rSE episodes/hour, or between MESOR and minimum rSE episodes/hour. We also evaluated the temporal distribution of time to treatment. Results: We analyzed 368 patients (58% males) with a median (p25 – p75) age of 4.2 (1.3–9.7) years. The MESOR was 15.3 (95% CI: 13.9–16.8) and the amplitude was 3.2 (95% CI: 1.1–5.3), p = 0.0024, demonstrating that the distribution is not uniform, but better described as varying throughout the day with a peak in the morning (11am–12 pm) and trough at night (11 pm–12 am). The duration from rSE onset to application of the first non-benzodiazepine antiseizure medication peaked during the early morning (2am–3 am) with a minimum during the afternoon (2 pm–3 pm) (p = 0.0179). Conclusions: The distribution of rSE onset is not uniform during the day. rSE onset shows a 24-h distribution with a peak in the mid-morning (11am–12 pm) and a trough at night (11 pm-12am).
AB - Purpose: To evaluate whether the onset of pediatric refractory status epilepticus (rSE) is related to time of day. Method: We analyzed the time of day for the onset of rSE in this prospective observational study performed from June 2011 to May 2019 in pediatric patients (1 month to 21 years of age). We evaluated the temporal distribution of pediatric rSE utilizing a cosinor analysis. We calculated the midline estimating statistic of rhythm (MESOR) and amplitude. MESOR is the estimated mean number of rSE episodes per hour if they were evenly distributed. Amplitude is the difference between MESOR and maximum rSE episodes/hour, or between MESOR and minimum rSE episodes/hour. We also evaluated the temporal distribution of time to treatment. Results: We analyzed 368 patients (58% males) with a median (p25 – p75) age of 4.2 (1.3–9.7) years. The MESOR was 15.3 (95% CI: 13.9–16.8) and the amplitude was 3.2 (95% CI: 1.1–5.3), p = 0.0024, demonstrating that the distribution is not uniform, but better described as varying throughout the day with a peak in the morning (11am–12 pm) and trough at night (11 pm–12 am). The duration from rSE onset to application of the first non-benzodiazepine antiseizure medication peaked during the early morning (2am–3 am) with a minimum during the afternoon (2 pm–3 pm) (p = 0.0179). Conclusions: The distribution of rSE onset is not uniform during the day. rSE onset shows a 24-h distribution with a peak in the mid-morning (11am–12 pm) and a trough at night (11 pm-12am).
KW - 24-hour rhythms
KW - Chronobiology
KW - Epilepsy
KW - Pediatric
KW - Status epilepticus
UR - http://www.scopus.com/inward/record.url?scp=85068939645&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068939645&partnerID=8YFLogxK
U2 - 10.1016/j.seizure.2019.06.017
DO - 10.1016/j.seizure.2019.06.017
M3 - Article
C2 - 31323566
AN - SCOPUS:85068939645
SN - 1059-1311
VL - 70
SP - 90
EP - 96
JO - Seizure : the journal of the British Epilepsy Association
JF - Seizure : the journal of the British Epilepsy Association
ER -