Sleep-wake pattern and sirkadiyen distribution of epileptic seizures in children

As many physiological events in the organism work in a circadian rhythmicity, some studies have revealed that some diseases also occured in a circadian rhythm. Daily periodicity of seizures in epilepsy patients has been known for over 2000 years. Many studies have shown that sleep and circadian rhythm can have an effect on seizure occurance, threshold and spread.We aimed to evaluate the relationship of the sleep/wake, and circadian patterns of childhood seizures to semiologic seizure subtypes, seizure-onset localization, and etiology in this study.The charts and the video recordings of the patients who were hospitalized from 1st January 2007 to 31st December 2011 at video-EEG Monitoring were retrospectively reviewed for clinico-electrographic seizures. Over a 5 year period, 170 patient and 909 seizures were included.Auras, dialeptic, atonic, myoclonic, hypomotor, gelastic seizures and epileptic spasms occured more often in wakefulness, while tonic, hypermotor and clonic seizures occurred more frequently in sleep (p<0.05). Auras, dialeptic, atonic, gelastic seizures, epileptic spasms are occurred more frequently during daytime while hypermotor seizures occurred more frequently at night (p<0.05).When we evaluated seizure according to seizure onset localisation, generalized seizures (12:00-18:00), frontal lobe seizures (24:00-06:00), temporal lobe seizures (06:00-09:00 and 12:00-15:00) and occipital lobe seizures (09:00-12:00 and 15:00-18:00) revealed specific circadian distributions (p<0.05).As a result, epileptic seizures occur in a circadian pattern. Sleep/wake cycling and circadian rhythm have an important role in the daily distribution of seizures. These factors have different effects on different brain regions. To explain these differences, future studies concerning the effects of circadian rhythym on different cortical areas and exploring the factors affecting the seizure treshold should be done. With the increasing of our knowledge, circadian patterns of seizures may be used for diagnostic and therapeutic purposes.