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Current Neurology and Neuroscience Reports

, 13:339

Topical Collection on Sleep


Approximately one-third of patients with epilepsy continue to have seizures despite antiepileptic therapy. Many seizures occur in diurnal, sleep-wake, circadian, or even monthly patterns. The relationship between biomarkers and state changes is still being investigated, but early results suggest that some of these patterns may be related to endogenous circadian patterns whereas others may be related to wakefulness and sleep or both. Chronotherapy, the application of treatment at times of greatest seizure susceptibility, is a technique that may optimize seizure control in selected patients. It may be used in the form of differential dosing, as preparations designed to deliver sustained or pulsatile drug delivery or in the form of ‘zeitgebers’ that shift endogenous rhythms. Early trials in epilepsy suggest that chronopharmacology may provide improved seizure control compared with conventional treatment in some patients. The present article reviews chronopharmacology in the treatment of epilepsy as well as future treatment avenues.

KeywordsEpilepsy Chronotherapy Chronopharmacology Chronopharmacokinetics Differential dosing Seizures Seizure patterns Diurnal patterns Closed loops Melatonin Light therapy Dim light melatonin onset DLMO Circadian rhythms Circadian pattern Suprachiasmatic nucleus Seizure tracking Seizure diary Chronopharmacodynamics Pharmacokinetics Pharmacodynamics This article is part of the Topical Collection on Sleep

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Autor: Sriram Ramgopal - Sigride Thome-Souza - Tobias Loddenkemper


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