Pub Date : 2025-10-31DOI: 10.1177/15357597251392099
Christophe Bernard, Gordon F Buchanan, Mohamad Z Koubeissi, Tobias Loddenkemper, Page B Pennell
Seizure occurrence in epilepsy is governed by biological rhythms, challenging the traditional view of seizures as random events. Circadian and multidien cycles shape seizure risk, with patient-specific chronotypes and stable temporal patterns observed across epilepsy types. The Molecular Oscillations and Rhythmicity of Epilepsy hypothesis posits that molecular oscillations-particularly those involving core clock genes and region-specific protein expression-create dynamic windows of increased seizure susceptibility. In epilepsy, these rhythms are altered, amplifying seizure risk through metabolic and genetic reorganization. Seizure timing is also modulated by hormonal cycles in women with catamenial epilepsy. Estrogen promotes seizures, while progesterone and its metabolite allopregnanolone are protective. Three distinct catamenial patterns guide diagnosis and treatment, though evidence for hormonal therapies remains limited. Personalized approaches, including adjunctive medications and cycle-specific dosing, may reduce seizure burden. Importantly, sudden unexpected death in epilepsy predominantly occurs at night, implicating sleep, circadian timing, and environmental factors. Nocturnal vulnerability is conserved across species, suggesting a biological mechanism potentially involving serotonin, which regulates respiration, cardiac function, and arousal. Finally, chronotherapeutic approaches offer a promising avenue for epilepsy management by aligning treatment with seizure timing. Time-adjusted dosing of antiseizure medications has shown improved outcomes in patients with predictable seizure patterns. Future strategies may include closed-loop systems and biomarker-guided interventions to shift seizure susceptibility rhythms. Together, these findings underscore the importance of temporal biology in epilepsy. Understanding when seizures occur provides insight into why they occur, paving the way for personalized, rhythm-informed care that enhances prediction, prevention, and treatment.
{"title":"Chronoepileptology: Mapping the Rhythms of Seizure Risk.","authors":"Christophe Bernard, Gordon F Buchanan, Mohamad Z Koubeissi, Tobias Loddenkemper, Page B Pennell","doi":"10.1177/15357597251392099","DOIUrl":"10.1177/15357597251392099","url":null,"abstract":"<p><p>Seizure occurrence in epilepsy is governed by biological rhythms, challenging the traditional view of seizures as random events. Circadian and multidien cycles shape seizure risk, with patient-specific chronotypes and stable temporal patterns observed across epilepsy types. The Molecular Oscillations and Rhythmicity of Epilepsy hypothesis posits that molecular oscillations-particularly those involving core clock genes and region-specific protein expression-create dynamic windows of increased seizure susceptibility. In epilepsy, these rhythms are altered, amplifying seizure risk through metabolic and genetic reorganization. Seizure timing is also modulated by hormonal cycles in women with catamenial epilepsy. Estrogen promotes seizures, while progesterone and its metabolite allopregnanolone are protective. Three distinct catamenial patterns guide diagnosis and treatment, though evidence for hormonal therapies remains limited. Personalized approaches, including adjunctive medications and cycle-specific dosing, may reduce seizure burden. Importantly, sudden unexpected death in epilepsy predominantly occurs at night, implicating sleep, circadian timing, and environmental factors. Nocturnal vulnerability is conserved across species, suggesting a biological mechanism potentially involving serotonin, which regulates respiration, cardiac function, and arousal. Finally, chronotherapeutic approaches offer a promising avenue for epilepsy management by aligning treatment with seizure timing. Time-adjusted dosing of antiseizure medications has shown improved outcomes in patients with predictable seizure patterns. Future strategies may include closed-loop systems and biomarker-guided interventions to shift seizure susceptibility rhythms. Together, these findings underscore the importance of temporal biology in epilepsy. Understanding when seizures occur provides insight into why they occur, paving the way for personalized, rhythm-informed care that enhances prediction, prevention, and treatment.</p>","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251392099"},"PeriodicalIF":6.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12578621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-23DOI: 10.1177/15357597251386752
Claude Steriade
{"title":"Temporal Lobe Epilepsy With GAD Antibodies-Time to Give Up, or Time to Double Down?","authors":"Claude Steriade","doi":"10.1177/15357597251386752","DOIUrl":"10.1177/15357597251386752","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251386752"},"PeriodicalIF":6.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12552221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145376541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1177/15357597251386661
Manuel Silva-Pérez, Jeannie Chin
{"title":"The Fast and the Very Fast: High-Frequency Oscillations in Alzheimer's Disease.","authors":"Manuel Silva-Pérez, Jeannie Chin","doi":"10.1177/15357597251386661","DOIUrl":"10.1177/15357597251386661","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251386661"},"PeriodicalIF":6.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-21DOI: 10.1177/15357597251377602
Edward Glasscock
{"title":"Resistance is not Futile: Common Genetic Factor Identified for Drug-Resistant Focal Epilepsy.","authors":"Edward Glasscock","doi":"10.1177/15357597251377602","DOIUrl":"10.1177/15357597251377602","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251377602"},"PeriodicalIF":6.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-15DOI: 10.1177/15357597251377606
Tong Pan, Louis T Dang
{"title":"Fire and Ice: Who's the Main Character in FCDII Pathogenesis?","authors":"Tong Pan, Louis T Dang","doi":"10.1177/15357597251377606","DOIUrl":"10.1177/15357597251377606","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251377606"},"PeriodicalIF":6.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-15eCollection Date: 2025-09-01DOI: 10.1177/15357597251370335
Vineet Punia
{"title":"Don't Sleep on It: The Prognostic Value of Electroencephalography (EEG) Spindles in the Critically ill.","authors":"Vineet Punia","doi":"10.1177/15357597251370335","DOIUrl":"10.1177/15357597251370335","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"332-334"},"PeriodicalIF":6.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-11DOI: 10.1177/15357597251372035
Katherine Noe
{"title":"Epilepsy Readmissions: The More Things Change the More They Stay the Same.","authors":"Katherine Noe","doi":"10.1177/15357597251372035","DOIUrl":"10.1177/15357597251372035","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251372035"},"PeriodicalIF":6.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1177/15357597251372049
Jeffrey H Goodman
{"title":"The Midline Thalamus: The New Kid in Town for Absence Seizure Therapy.","authors":"Jeffrey H Goodman","doi":"10.1177/15357597251372049","DOIUrl":"10.1177/15357597251372049","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251372049"},"PeriodicalIF":6.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-19DOI: 10.1177/15357597251370432
Jacy L Wagnon
{"title":"Knockdown-Replace: A New Dynamic for Treatment of Dynamin-1 Related developmental and epileptic encephalopathy (DEE).","authors":"Jacy L Wagnon","doi":"10.1177/15357597251370432","DOIUrl":"https://doi.org/10.1177/15357597251370432","url":null,"abstract":"","PeriodicalId":11742,"journal":{"name":"Epilepsy Currents","volume":" ","pages":"15357597251370432"},"PeriodicalIF":6.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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