title: Chronobiology of epilepsy: diagnostic and therapeutic implications of chrono-epileptology.
abstract: The combination of chronobiology and epilepsy offers novel diagnostic and therapeutic management options. Knowledge of the interactions between circadian periodicity, entrainment, sleep patterns, and epilepsy may provide additional diagnostic options beyond sleep deprivation and extended release medication formulations. It may also provide novel insights into the physiologic, biochemical, and genetic regulation processes of epilepsy and the circadian clock, rendering new treatment options. Temporal fluctuations of seizure susceptibility based on sleep homeostasis and circadian phase in selected epilepsies may provide predictability based on mathematical models. Chrono-epileptology offers opportunities for individualized patient-oriented treatment paradigms based on chrono-pharmacology, differential medication dosing, chrono-drug delivery systems, and utilization of "zeitgebers" such as chronobiotics or light-therapy and desynchronization strategies among others.
authors.affiliation: Department of Neurology, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA. tobias.loddenkemper@childrens.harvard.edu
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
authors.forename: Steven W
authors.initials: SW
authors.lastname: Lockley
authors.forename: Joseph
authors.initials: J
authors.lastname: Kaleyias
authors.forename: Sanjeev V
authors.initials: SV
authors.lastname: Kothare
mesh_terms: D001921:Brain / Q000503:physiopathology*; D058256:Brain Waves; D002940:Circadian Rhythm; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D006706:Homeostasis; D006801:Humans; D009043:Motor Activity; D009434:Neural Pathways / Q000503:physiopathology; D011237:Predictive Value of Tests; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy