Circadian rhythm and epilepsy

Khan, S.; Nobili, L.; Khatami, Ramin; Loddenkemper, T.; Cajochen, C.; Dijk, D. J.; Eriksson, S. H. (2018). Circadian rhythm and epilepsy. Lancet neurology, 17(12), pp. 1098-1108. Elsevier 10.1016/s1474-4422(18)30335-1

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Advances in diagnostic technology, including chronic intracranial EEG recordings, have confirmed the clinical observation of different temporal patterns of epileptic activity and seizure occurrence over a 24-h period. The rhythmic patterns in epileptic activity and seizure occurrence are probably related to vigilance states and circadian variation in excitatory and inhibitory balance. Core circadian genes BMAL1 and CLOCK, which code for transcription factors, have been shown to influence excitability and seizure threshold. Despite uncertainties about the relative contribution of vigilance states versus circadian rhythmicity, including circadian factors such as seizure timing improves sensitivity of seizure prediction algorithms in individual patients. Improved prediction of seizure occurrence opens the possibility for personalised antiepileptic drug-dosing regimens timed to particular phases of the circadian cycle to improve seizure control and to reduce side-effects and risks associated with seizures. Further studies are needed to clarify the pathways through which rhythmic patterns of epileptic activity are generated, because this might also inform future treatment options.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Khatami, Ramin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1474-4422

Publisher:

Elsevier

Language:

English

Submitter:

Panagiota Milona

Date Deposited:

27 Mar 2019 16:00

Last Modified:

27 Oct 2019 12:57

Publisher DOI:

10.1016/s1474-4422(18)30335-1

PubMed ID:

30366868

BORIS DOI:

10.7892/boris.124716

URI:

https://boris.unibe.ch/id/eprint/124716

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