van Campen Jolien S, Valentijn Floris A, Jansen Floor E, Joëls Marian, Braun Kees P J
Department of Pediatric Neurology, University Medical Center Utrecht, The Netherlands; Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands.
Department of Pediatric Neurology, University Medical Center Utrecht, The Netherlands.
Epilepsy Behav. 2015 Jun;47:132-7. doi: 10.1016/j.yebeh.2015.04.071. Epub 2015 May 14.
Stress is the seizure precipitant most often reported by patients with epilepsy or their caregivers. The relation between stress and seizures is presumably mediated by stress hormones such as cortisol, affecting neuronal excitability. Endogenous cortisol is released in a circadian pattern. To gain insight into the relation between the circadian rhythm of cortisol and seizure occurrence, we systematically reviewed studies on the diurnal distribution of epileptic seizures in children and adults and linked the results to the circadian rhythm of cortisol.
A structured literature search was conducted to identify relevant articles, combining the terms 'epilepsy' and 'circadian seizure distribution', plus synonyms. Articles were screened using predefined selection criteria. Data on 24-hour seizure occurrence were extracted, combined, and related to a standard circadian rhythm of cortisol.
Fifteen relevant articles were identified of which twelve could be used for data aggregation. Overall, seizure occurrence showed a sharp rise in the early morning, followed by a gradual decline, similar to cortisol rhythmicity. The occurrence of generalized seizures and focal seizures originating from the parietal lobe in particular followed the circadian rhythm of cortisol.
The diurnal occurrence of epileptic seizures shows similarities to the circadian rhythm of cortisol. These results support the hypothesis that circadian fluctuations in stress hormone level influence the occurrence of epileptic seizures.
压力是癫痫患者或其护理人员最常报告的癫痫发作诱发因素。压力与癫痫发作之间的关系可能是由皮质醇等应激激素介导的，这些激素会影响神经元兴奋性。内源性皮质醇以昼夜节律模式释放。为深入了解皮质醇昼夜节律与癫痫发作之间的关系，我们系统回顾了关于儿童和成人癫痫发作昼夜分布的研究，并将结果与皮质醇的昼夜节律联系起来。
进行结构化文献检索以识别相关文章，将“癫痫”和“昼夜癫痫发作分布”等术语与同义词相结合。使用预定义的选择标准筛选文章。提取、合并关于24小时癫痫发作情况的数据，并将其与皮质醇的标准昼夜节律相关联。
共识别出15篇相关文章，其中12篇可用于数据汇总。总体而言，癫痫发作在清晨急剧增加，随后逐渐下降，与皮质醇节律相似。特别是全身性发作和源自顶叶的局灶性发作的发生遵循皮质醇的昼夜节律。
癫痫发作的昼夜发生情况与皮质醇的昼夜节律相似。这些结果支持应激激素水平的昼夜波动影响癫痫发作发生的假说。
