University of Southern California, Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA.
Swedish Epilepsy Center, 550 17th Ave suite 540, Seattle, WA, 98122, USA.
Seizure. 2021 Feb;85:145-150. doi: 10.1016/j.seizure.2020.12.002. Epub 2021 Jan 13.
There are multidien patterns of seizure occurrence. Predicting seizure risk may be easier with biomarker correlates to multidien patterns. We hypothesize multiday hyper or hypoglycemia contributes to seizure risk.
In a type I diabetic (T1D) with focal onset epilepsy with continuous glucose monitoring (CGM) and responsive neurostimulation (RNS) devices, we studied multiday interictal activities (IEA), seizures, and glucose. Hourly CGM data was matched to hourly RNS captures of interictal and ictal activities over 33 months. RNS detection settings were unchanged. Multidien cycles were analyzed, active blocks of IEA and ictal episodes defined, and tissue glucose averages studied.
Average glucose was 161 mg/dl. A 40-day cycle of interictal and ictal activities occurred, though no similar glucose cycle was evident. Glucose elevations relative to patient average were associated with increases in IEA but not seizure. Frequent seizures were not associated with obvious elevations or decreases of glucose from baseline, most seizures occurred at +/- 10 mg/dl of average daily glucose (i.e. 150-170 mg/dl).
Tissue glucose may influence IEA but may not influence multiday seizure activity or very frequent seizures. In an ambulatory T1D patient multiday hypo or hyperglycemic extremes do not appear to provoke seizure activities.
癫痫发作存在多日周期模式。具有多日周期模式的生物标志物相关性可能更有助于预测癫痫发作风险。我们假设多日高血糖或低血糖会增加癫痫发作风险。
在一名患有局灶性起始性癫痫且接受连续血糖监测（CGM）和反应性神经刺激（RNS）设备的 1 型糖尿病（T1D）患者中，我们研究了多日发作间期活动（IEA）、癫痫发作和血糖。在 33 个月的时间里，将每小时的 CGM 数据与每小时 RNS 捕捉到的发作间期和发作期活动进行匹配。RNS 检测设置保持不变。分析多日周期，定义发作间期活动和发作期活动的活跃块，并研究组织血糖平均值。
平均血糖为 161mg/dl。出现了 40 天的发作间期和发作期活动周期，但没有明显的类似血糖周期。与患者平均血糖相比，血糖升高与发作间期活动增加有关，但与癫痫发作无关。频繁的癫痫发作与血糖明显升高或降低无关，大多数癫痫发作发生在平均每日血糖的 +/-10mg/dl（即 150-170mg/dl）范围内。
组织血糖可能会影响发作间期活动，但可能不会影响多日癫痫发作活动或非常频繁的癫痫发作。在一名有活动能力的 T1D 患者中，多日低血糖或高血糖极值似乎不会引发癫痫活动。
