Revisiting an ancient legend: influence of the lunar cycle on occurrence of first‐ever unprovoked seizures

Abstract

Background The mythical effect of the lunar cycle on seizures has been debated over time. Previously healthy individuals presenting with first‐ever seizures in whom investigations are negative often invoke questions about potential reasons including a full moon. Aims To determine whether there is a temporal relationship between the occurrence of the first‐ever unprovoked seizure and the lunar cycle. Methods We studied adults who presented with a first‐ever unprovoked seizure to two tertiary centres in Australia. Seizure onset time was obtained from the emergency department and ambulance documentations. We used Poisson regression modelling and incidence rate ratios (IRR) to determine whether seizures have a preponderance for a particular lunar phase. We performed further analysis on ‘first seizure epilepsy’ and ‘first seizure not epilepsy’ subgroups based on the International League Against Epilepsy criteria for a diagnosis of epilepsy after a single unprovoked seizure. Results We analysed 1710 patients (38% females; median age 39 years), of whom 18% had epileptiform abnormalities on electroencephalogram (EEG) and potentially epileptogenic lesions were detected on neuroimaging in 28%. Based on the EEG and imaging findings, 684 (40%) patients were categorised as ‘first seizure epilepsy’ and 1026 (60%) ‘first seizure not epilepsy’. The whole cohort and subgroup analysis demonstrated no significant difference in the seizure occurrence among the four lunar quarters. Conclusions First unprovoked seizures are not influenced by the lunar cycle. Patients pondering the cause of their first‐ever unprovoked seizure can be reassured that the full moon was not responsible.

Relationship of epileptic seizures with lunar cycle and seasons

“…A review of the studies on neurological and psychiatric conditions reveals no relationship between the phases of the moon and aggressive behavior [9] or psychiatric admissions [10]. Similar to our study, Wang et al [4] did not find a relationship between the phases of the moon and epileptic seizures. In contrast, Polychronopoulos et al [5] reported an increase in emergency department presentations due to seizures during the full moon phase.…”

“…There are patients claiming that their seizures are predictably triggered or exacerbated by the full moon, which is supported by previous studies in the literature [5]. In contrast, several researchers have found no relationship between the phases of the moon and epileptic seizures [4,9,10].…”

“…Sleep deprivation, alcohol intake, not taking prescribed medication, and bright lights have previously been reported as factors that facilitate seizures in patients with epilepsy [3]. However, there are different views concerning the increase in the frequency of seizures according to the phases of the moon [4,5]. In addition, the relationship between the phases of the moon and neuropsychiatric conditions has been a matter of curiosity for every society [6].…”

Moon and Health: Myth or Reality?

“…They analysed 1710 patients, and various subgroups and the cohort demonstrated that there was no notable variance in the occurrence of the seizures in the four lunar quadrants. It deduced that the lunar cycle does not influence the first unprovoked seizures [11]. Sudden unexpected death in epilepsy (SUDEP) is an important cause of the premature death of patients suffering from epilepsy, yet it is rare.…”

Chronobiology of epilepsy and sudden unexpected death in epilepsy

“…In light of this evidence, the authors proposed that these observations were due to nocturnal illumination, and not phase of the moon ( Baxendale and Fisher, 2008 ). A relationship between both the onset of first-time unprovoked seizure or onset of pediatric febrile seizures and phase of the moon has also not been supported ( Kim et al, 2019 ; Wang et al, 2020 ).…”