The onset of pediatric refractory status epilepticus is not distributed uniformly during the day

Iván Sánchez Fernández; Marina Gaínza-Lein; Nicholas S. Abend; Marta Amengual-Gual; Anne Anderson; Ravindra Arya; J. Nicholas Brenton; Jessica L. Carpenter; Kevin E. Chapman; Justice Clark; Raquel Farias-Moeller; William Davis Gaillard; Tracy A. Glauser; Joshua Goldstein; Howard P. Goodkin; Réjean M. Guerriero; Kurt Hecox; Michele Jackson; Kush Kapur; Sarah A. Kelley; Eric H.W. Kossoff; Yi Chen Lai; Tiffani L. McDonough; Mohamad A. Mikati; Lindsey A. Morgan; Edward J. Novotny; Adam P. Ostendorf; Eric T. Payne; Katrina Peariso; Juan Piantino; James J. Riviello; Kumar Sannagowdara; Carl E. Stafstrom; Robert C. Tasker; Dmitry Tchapyjnikov; Alexis A. Topjian; Alejandra Vasquez; Mark S. Wainwright; Angus Wilfong; Korwyn Williams; Tobias Loddenkemper

doi:10.1016/j.seizure.2019.06.017

The onset of pediatric refractory status epilepticus is not distributed uniformly during the day

Iván Sánchez Fernández, Marina Gaínza-Lein, Nicholas S. Abend, Marta Amengual-Gual, Anne Anderson, Ravindra Arya, J. Nicholas Brenton, Jessica L. Carpenter, Kevin E. Chapman, Justice Clark, Raquel Farias-Moeller, William Davis Gaillard, Tracy A. Glauser, Joshua Goldstein, Howard P. Goodkin, Réjean M. Guerriero, Kurt Hecox, Michele Jackson, Kush Kapur, Sarah A. KelleyEric H.W. Kossoff, Yi Chen Lai, Tiffani L. McDonough, Mohamad A. Mikati, Lindsey A. Morgan, Edward J. Novotny, Adam P. Ostendorf, Eric T. Payne, Katrina Peariso, Juan Piantino, James J. Riviello, Kumar Sannagowdara, Carl E. Stafstrom, Robert C. Tasker, Dmitry Tchapyjnikov, Alexis A. Topjian, Alejandra Vasquez, Mark S. Wainwright, Angus Wilfong, Korwyn Williams, Tobias Loddenkemper

Pediatrics

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Purpose: To evaluate whether the onset of pediatric refractory status epilepticus (rSE) is related to time of day. Method: We analyzed the time of day for the onset of rSE in this prospective observational study performed from June 2011 to May 2019 in pediatric patients (1 month to 21 years of age). We evaluated the temporal distribution of pediatric rSE utilizing a cosinor analysis. We calculated the midline estimating statistic of rhythm (MESOR) and amplitude. MESOR is the estimated mean number of rSE episodes per hour if they were evenly distributed. Amplitude is the difference between MESOR and maximum rSE episodes/hour, or between MESOR and minimum rSE episodes/hour. We also evaluated the temporal distribution of time to treatment. Results: We analyzed 368 patients (58% males) with a median (p₂₅ – p₇₅) age of 4.2 (1.3–9.7) years. The MESOR was 15.3 (95% CI: 13.9–16.8) and the amplitude was 3.2 (95% CI: 1.1–5.3), p = 0.0024, demonstrating that the distribution is not uniform, but better described as varying throughout the day with a peak in the morning (11am–12 pm) and trough at night (11 pm–12 am). The duration from rSE onset to application of the first non-benzodiazepine antiseizure medication peaked during the early morning (2am–3 am) with a minimum during the afternoon (2 pm–3 pm) (p = 0.0179). Conclusions: The distribution of rSE onset is not uniform during the day. rSE onset shows a 24-h distribution with a peak in the mid-morning (11am–12 pm) and a trough at night (11 pm-12am).

Original language	English (US)
Pages (from-to)	90-96
Number of pages	7
Journal	Seizure
Volume	70
DOIs	https://doi.org/10.1016/j.seizure.2019.06.017
State	Published - Aug 2019

Keywords

24-hour rhythms
Chronobiology
Epilepsy
Pediatric
Status epilepticus

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.1016/j.seizure.2019.06.017

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Sánchez Fernández, I., Gaínza-Lein, M., Abend, N. S., Amengual-Gual, M., Anderson, A., Arya, R., Brenton, J. N., Carpenter, J. L., Chapman, K. E., Clark, J., Farias-Moeller, R., Davis Gaillard, W., Glauser, T. A., Goldstein, J., Goodkin, H. P., Guerriero, R. M., Hecox, K., Jackson, M., Kapur, K., ... Loddenkemper, T. (2019). The onset of pediatric refractory status epilepticus is not distributed uniformly during the day. Seizure, 70, 90-96. https://doi.org/10.1016/j.seizure.2019.06.017

Sánchez Fernández, I, Gaínza-Lein, M, Abend, NS, Amengual-Gual, M, Anderson, A, Arya, R, Brenton, JN, Carpenter, JL, Chapman, KE, Clark, J, Farias-Moeller, R, Davis Gaillard, W, Glauser, TA, Goldstein, J, Goodkin, HP, Guerriero, RM, Hecox, K, Jackson, M, Kapur, K, Kelley, SA, Kossoff, EHW, Lai, YC, McDonough, TL, Mikati, MA, Morgan, LA, Novotny, EJ, Ostendorf, AP, Payne, ET, Peariso, K, Piantino, J, Riviello, JJ, Sannagowdara, K, Stafstrom, CE, Tasker, RC, Tchapyjnikov, D, Topjian, AA, Vasquez, A, Wainwright, MS, Wilfong, A, Williams, K & Loddenkemper, T 2019, 'The onset of pediatric refractory status epilepticus is not distributed uniformly during the day', Seizure, vol. 70, pp. 90-96. https://doi.org/10.1016/j.seizure.2019.06.017

@article{8da30a698d91442ab6c08e9d03e84de7,

title = "The onset of pediatric refractory status epilepticus is not distributed uniformly during the day",

abstract = "Purpose: To evaluate whether the onset of pediatric refractory status epilepticus (rSE) is related to time of day. Method: We analyzed the time of day for the onset of rSE in this prospective observational study performed from June 2011 to May 2019 in pediatric patients (1 month to 21 years of age). We evaluated the temporal distribution of pediatric rSE utilizing a cosinor analysis. We calculated the midline estimating statistic of rhythm (MESOR) and amplitude. MESOR is the estimated mean number of rSE episodes per hour if they were evenly distributed. Amplitude is the difference between MESOR and maximum rSE episodes/hour, or between MESOR and minimum rSE episodes/hour. We also evaluated the temporal distribution of time to treatment. Results: We analyzed 368 patients (58% males) with a median (p25 – p75) age of 4.2 (1.3–9.7) years. The MESOR was 15.3 (95% CI: 13.9–16.8) and the amplitude was 3.2 (95% CI: 1.1–5.3), p = 0.0024, demonstrating that the distribution is not uniform, but better described as varying throughout the day with a peak in the morning (11am–12 pm) and trough at night (11 pm–12 am). The duration from rSE onset to application of the first non-benzodiazepine antiseizure medication peaked during the early morning (2am–3 am) with a minimum during the afternoon (2 pm–3 pm) (p = 0.0179). Conclusions: The distribution of rSE onset is not uniform during the day. rSE onset shows a 24-h distribution with a peak in the mid-morning (11am–12 pm) and a trough at night (11 pm-12am).",

keywords = "24-hour rhythms, Chronobiology, Epilepsy, Pediatric, Status epilepticus",

author = "{S{\'a}nchez Fern{\'a}ndez}, Iv{\'a}n and Marina Ga{\'i}nza-Lein and Abend, {Nicholas S.} and Marta Amengual-Gual and Anne Anderson and Ravindra Arya and Brenton, {J. Nicholas} and Carpenter, {Jessica L.} and Chapman, {Kevin E.} and Justice Clark and Raquel Farias-Moeller and {Davis Gaillard}, William and Glauser, {Tracy A.} and Joshua Goldstein and Goodkin, {Howard P.} and Guerriero, {R{\'e}jean M.} and Kurt Hecox and Michele Jackson and Kush Kapur and Kelley, {Sarah A.} and Kossoff, {Eric H.W.} and Lai, {Yi Chen} and McDonough, {Tiffani L.} and Mikati, {Mohamad A.} and Morgan, {Lindsey A.} and Novotny, {Edward J.} and Ostendorf, {Adam P.} and Payne, {Eric T.} and Katrina Peariso and Juan Piantino and Riviello, {James J.} and Kumar Sannagowdara and Stafstrom, {Carl E.} and Tasker, {Robert C.} and Dmitry Tchapyjnikov and Topjian, {Alexis A.} and Alejandra Vasquez and Wainwright, {Mark S.} and Angus Wilfong and Korwyn Williams and Tobias Loddenkemper",

note = "Publisher Copyright: {\textcopyright} 2019 British Epilepsy Association",

year = "2019",

month = aug,

doi = "10.1016/j.seizure.2019.06.017",

language = "English (US)",

volume = "70",

pages = "90--96",

journal = "Seizure",

issn = "1059-1311",

publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - The onset of pediatric refractory status epilepticus is not distributed uniformly during the day

AU - Sánchez Fernández, Iván

AU - Gaínza-Lein, Marina

AU - Abend, Nicholas S.

AU - Amengual-Gual, Marta

AU - Anderson, Anne

AU - Arya, Ravindra

AU - Brenton, J. Nicholas

AU - Carpenter, Jessica L.

AU - Chapman, Kevin E.

AU - Clark, Justice

AU - Farias-Moeller, Raquel

AU - Davis Gaillard, William

AU - Glauser, Tracy A.

AU - Goldstein, Joshua

AU - Goodkin, Howard P.

AU - Guerriero, Réjean M.

AU - Hecox, Kurt

AU - Jackson, Michele

AU - Kapur, Kush

AU - Kelley, Sarah A.

AU - Kossoff, Eric H.W.

AU - Lai, Yi Chen

AU - McDonough, Tiffani L.

AU - Mikati, Mohamad A.

AU - Morgan, Lindsey A.

AU - Novotny, Edward J.

AU - Ostendorf, Adam P.

AU - Payne, Eric T.

AU - Peariso, Katrina

AU - Piantino, Juan

AU - Riviello, James J.

AU - Sannagowdara, Kumar

AU - Stafstrom, Carl E.

AU - Tasker, Robert C.

AU - Tchapyjnikov, Dmitry

AU - Topjian, Alexis A.

AU - Vasquez, Alejandra

AU - Wainwright, Mark S.

AU - Wilfong, Angus

AU - Williams, Korwyn

AU - Loddenkemper, Tobias

PY - 2019/8

Y1 - 2019/8

N2 - Purpose: To evaluate whether the onset of pediatric refractory status epilepticus (rSE) is related to time of day. Method: We analyzed the time of day for the onset of rSE in this prospective observational study performed from June 2011 to May 2019 in pediatric patients (1 month to 21 years of age). We evaluated the temporal distribution of pediatric rSE utilizing a cosinor analysis. We calculated the midline estimating statistic of rhythm (MESOR) and amplitude. MESOR is the estimated mean number of rSE episodes per hour if they were evenly distributed. Amplitude is the difference between MESOR and maximum rSE episodes/hour, or between MESOR and minimum rSE episodes/hour. We also evaluated the temporal distribution of time to treatment. Results: We analyzed 368 patients (58% males) with a median (p25 – p75) age of 4.2 (1.3–9.7) years. The MESOR was 15.3 (95% CI: 13.9–16.8) and the amplitude was 3.2 (95% CI: 1.1–5.3), p = 0.0024, demonstrating that the distribution is not uniform, but better described as varying throughout the day with a peak in the morning (11am–12 pm) and trough at night (11 pm–12 am). The duration from rSE onset to application of the first non-benzodiazepine antiseizure medication peaked during the early morning (2am–3 am) with a minimum during the afternoon (2 pm–3 pm) (p = 0.0179). Conclusions: The distribution of rSE onset is not uniform during the day. rSE onset shows a 24-h distribution with a peak in the mid-morning (11am–12 pm) and a trough at night (11 pm-12am).

AB - Purpose: To evaluate whether the onset of pediatric refractory status epilepticus (rSE) is related to time of day. Method: We analyzed the time of day for the onset of rSE in this prospective observational study performed from June 2011 to May 2019 in pediatric patients (1 month to 21 years of age). We evaluated the temporal distribution of pediatric rSE utilizing a cosinor analysis. We calculated the midline estimating statistic of rhythm (MESOR) and amplitude. MESOR is the estimated mean number of rSE episodes per hour if they were evenly distributed. Amplitude is the difference between MESOR and maximum rSE episodes/hour, or between MESOR and minimum rSE episodes/hour. We also evaluated the temporal distribution of time to treatment. Results: We analyzed 368 patients (58% males) with a median (p25 – p75) age of 4.2 (1.3–9.7) years. The MESOR was 15.3 (95% CI: 13.9–16.8) and the amplitude was 3.2 (95% CI: 1.1–5.3), p = 0.0024, demonstrating that the distribution is not uniform, but better described as varying throughout the day with a peak in the morning (11am–12 pm) and trough at night (11 pm–12 am). The duration from rSE onset to application of the first non-benzodiazepine antiseizure medication peaked during the early morning (2am–3 am) with a minimum during the afternoon (2 pm–3 pm) (p = 0.0179). Conclusions: The distribution of rSE onset is not uniform during the day. rSE onset shows a 24-h distribution with a peak in the mid-morning (11am–12 pm) and a trough at night (11 pm-12am).

KW - 24-hour rhythms

KW - Chronobiology

KW - Epilepsy

KW - Pediatric

KW - Status epilepticus

UR - http://www.scopus.com/inward/record.url?scp=85068939645&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068939645&partnerID=8YFLogxK

U2 - 10.1016/j.seizure.2019.06.017

DO - 10.1016/j.seizure.2019.06.017

M3 - Article

C2 - 31323566

AN - SCOPUS:85068939645

SN - 1059-1311

VL - 70

SP - 90

EP - 96

JO - Seizure

JF - Seizure

ER -

The onset of pediatric refractory status epilepticus is not distributed uniformly during the day

Abstract

Keywords

ASJC Scopus subject areas

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