Clinical Edge

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More Severe Seizure Patterns Favor Daytime

Epilepsia; ePub 2018 Apr 23; Goldenholz, et al

With the exception of status epilepticus (SE) in children, recent data indicate that more severe seizure patterns favor daytime. This suggests distinct day/night preferences for different seizure patterns in children and adults. Using approximations based on presumed US time zones, researchers characterized day and nighttime seizure patterns in a patient‐reported database, Seizure Tracker. A total of 632,995 seizures (n=9,698 patients) were classified into 4 categories: isolated seizure event (ISE), cluster without status epilepticus (CWOS), cluster including status epilepticus (CIS), and status epilepticus (SE). They found:

  • In adults, ISE was more likely at night compared to CWOS and to CIS.
  • The odds ratios (ORs) for ISE vs SE and CWOS vs SE were not significantly different regardless of cluster definition.
  • In children, ISE was less likely at night compared to SE.
  • ISE was more likely at night compared to CWOS and CIS.
  • CWOS was more likely during the night compared to CIS.


Goldenholz DM, Rakesh K, Kapur K, et al. Different as night and day: Patterns of isolated seizures, clusters, and status epilepticus. [Published online ahead of print April 23, 2018]. Epilepsia. doi:10.1111/epi.14076.

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