The cyclical organization of seizures in epilepsy has been described since antiquity. However, historical explanations for seizure cycles-based on celestial, hormonal, and environmental factors-have only recently become testable with the advent of chronic electroencephalography (cEEG) and modern statistical techniques. Here, factors purported over millennia to influence seizure timing are viewed through a contemporary lens. We discuss the emerging concept that seizures are organized over multiple timescales, each involving differential influences of external and endogenous rhythm generators. Leveraging large cEEG datasets and circular statistics appropriate for cyclical phenomena, we present new evidence for circadian (day-night), multidien (multi-day), and circannual (about-yearly) variation in seizure activity. Modulation of seizure timing by multiscale temporal variables has implications for diagnosis and therapy in clinical epilepsy. Uncovering the mechanistic basis for seizure cycles, particularly the factors that govern multidien periodicity, will be a major focus of future work.

中文翻译：

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癫痫发作时间提示

自古以来就已经描述了癫痫发作的周期性组织。然而，随着慢性脑电图 (cEEG) 和现代统计技术的出现，基于天体、激素和环境因素对癫痫发作周期的历史解释直到最近才变得可检验。在这里，通过当代视角观察了数千年来影响癫痫发作时间的因素。我们讨论了癫痫发作在多个时间尺度上组织的新兴概念，每个时间尺度都涉及外部和内源性节律发生器的不同影响。利用适用于周期性现象的大型 cEEG 数据集和循环统计数据，我们为癫痫活动的昼夜节律（昼夜）、多日（多日）和年度（大约每年）变化提供了新证据。通过多尺度时间变量调节癫痫发作时间对临床癫痫的诊断和治疗有影响。揭示癫痫发作周期的机制基础，特别是控制多维周期的因素，将是未来工作的主要重点。