Abstract
To identify factors that influence diurnal and sleep/wake seizure timing in children undergoing tapered drug withdrawal in an epilepsy monitoring unit. Medical charts of patients that underwent video-EEG were reviewed. Seizures were evaluated based on their occurrence in three-hour time intervals (bins) and between wakefulness and sleep. Patients were classified according to EEG localisation and age: infants (≤3 years), children (3-12 years), and adolescents (>12-21 years). Analysis utilising generalised estimating equations with a negative binomial distribution was performed. A total of 390 patients (188 girls; mean age: 9.2 years; SD: 6.0) had 1,754 seizures. Generalised seizures (109 patients; 490 seizures) occurred more during wakefulness (p<0.001) and during the day (p><0.001). modelling revealed a greater occurrence of seizures at night with increasing age (p="0.046)." temporal lobe seizures (62 patients; 271 seizures) occurred overall more frequently during wakefulness (p="0.03)." frontal lobe seizures (41 patients; 184 seizures) occurred more frequently during wakefulness in infants (p><0.05) and more frequently during sleep in adolescents (p><0.0001). adolescents with frontal lobe seizures were 3.6 times more likely to have seizures during sleep compared to other children (95% ci: 1.8-7.2). these findings are suggestive of changes in circadian rhythmicity that may alter seizure susceptibility in different age groups. the results may assist in prediction of periods of greatest seizure propensity.>
