Weather as a risk factor for epileptic seizures: A case‐crossover study

Rakers, Florian; Walther, Mario; Schiffner, René; Rupprecht, Sven; Rasche, Marius; Kockler, Michael; Witte, Otto W.; Schlattmann, Peter; Schwab, Matthias

doi:10.1111/epi.13776

Cited by 56 publications

(65 citation statements)

References 40 publications

(62 reference statements)

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“…The authors conclude that low air pressure and high relative humidity are associated with an increased risk for epileptic seizures, whereas high ambient temperatures seem to decrease seizure risk. They note that these results require further replication across different climate regions and cohorts before reliable clinical recommendations can be made (12). The results of our study show only a statistically significant negative correlation between subjective sensation of the severity of seizures and atmospheric pressure changes in male subjects.…”

Section: Discussioncontrasting

confidence: 46%

The effect of atmospheric pressure on frequency and patient's subjective perception of epileptic seizure severity

Kovačević¹,

Vidović²,

Avdić³

et al. 2018

Acta Med Sal

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Objective: The aim of this study was to determine the atmospheric pressure effect on the frequency of certain types of epileptic seizures as well as on patient's subjective perception of the seizure "severity". Subjects and methods:The study was conducted prospectively, from April, 4th 2012. and it lasted for one year. Included were patients with epilepsy, without cognitive impairment or with mild cognitive impairment (a score of mini mental status MMS> 23), who regularly take antiepileptics. Daily personal epileptic seizure calendar of all subjects was monitored for twelve months, and atmospheric pressure value was monitored using biometeorological calendar. The calendar recorded the date, the time of seizure, with the assessment of the seizure "severity" (from 1 to 5), and based on autoanamnestic and heteroanamnestic data. Results:Of 150 subjects included in the study, 74 (49.3%) were male, while 76 (50.7%) were female. There was no statistically significant difference in age between male and female subjects, with a probability of p = 0.082 (t = -1.751). There were 58 patients with generalized tonic-clonic seizures, (total 58), 56 patients with simple focal seizures, and 36 with complex focal seizures. The seizure frequency in both male and female subjects did not depend on the atmospheric pressure value. However, the seizure frequency is statistically more frequent in days of changing in atmospheric pressure (either decrease or increase) in both men and women. Pearson correlation revealed only statistically significant (p <0.031) negative correlation of the seizure severity with the difference (change) in atmospheric pressure in male subjects, and where the correlation was extremely weak with the coefficient of correlation of r = -0,201. Association of seizure type with atmospheric pressure and its changes did not reach statistical significance. Conclusion:These results certainly require further monitoring of associated biometerological parameters and their effects on seizure onset.

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Section: Discussioncontrasting

confidence: 46%

The effect of atmospheric pressure on frequency and patient's subjective perception of epileptic seizure severity

Kovačević¹,

Vidović²,

Avdić³

et al. 2018

Acta Med Sal

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“…The multidien cycles observed for most patients highlight the presence of slow variables (>24 hours) that influence seizure susceptibility [28,38,44]. The causal factors of these slower cycles may be regulated by the body [45] or relate to external factors such as weather [46] or behavior [47]. Identification of the causal factors will undoubtedly improve our understanding of seizures and improve techniques that make seizures predictable.…”

Section: Seizures Tended To Cluster After Lead Seizures the Period Dmentioning

confidence: 99%

Critical slowing as a biomarker for seizure susceptibility

Maturana

Meisel

Dell

et al. 2019

Preprint

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words)The human brain has the capacity to rapidly change state, and in epilepsy these state changes can be catastrophic, resulting in loss of consciousness, injury and even death. Theoretical interpretations considering the brain as a dynamical system would suggest that prior to a seizure recorded brain signals may exhibit critical slowing, a warning signal preceding many critical transitions in dynamical systems. Using long-term intracranial electroencephalography (iEEG) recordings from fourteen patients with focal epilepsy, we found key signatures of critical slowing prior to seizures. Signals related to a critically slowing process fluctuated over temporally long scales (hours to days), longer than would be detectable in standard clinical evaluation settings. Seizure risk was associated with a combination of these signals together with epileptiform discharges. These results provide strong validation of theoretical models and demonstrate that critical slowing is a reliable indicator that could be used in seizure forecasting algorithms.

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“…In spite of some patients report of the weather, or weather changes, as one of their possible seizure triggers [1,7], the evidence supporting a significant influence of specific meteorological parameters in seizure frequency is scarce and inconsistent [8][9][10][11][12][13][14][15][16]. Thus, it is still unclear what the influence of weather is on the general risk of seizures.…”

Section: Introductionmentioning

confidence: 99%

Influence of weather on seizure frequency — Clinical experience in the emergency room of a tertiary hospital

Brás

Barros

Vaz

et al. 2018

Epilepsy & Behavior

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Introduction: Some patients with epilepsy identify weather as a typical seizure trigger. However, it is yet to be confirmed. Thus, we aimed to evaluate possible relationships between daily meteorological conditions and the daily incidence of seizures. Methods: This was a retrospective single center study that included adult patients who were admitted to the emergency room of a tertiary hospital in Lisbon, with a seizure, between January and December 2015. The influence of temperature, atmospheric pressure, relative humidity, wind, precipitation, sunlight duration, and the seasons on seizure frequency was evaluated. Results: Three hundred seven seizure episodes were included (from 286 patients) in a total of 365 days, 117 (38.1%) first unprovoked seizures and 190 (61.9%) with previous seizure episodes. There were 82 days with higher incidence of seizures (≥2) and 171 days without seizures. We found a statistical significant relation between lower ambient temperatures, higher atmospheric pressure, and higher maximum humidity with days with two or more seizures. We also found a statistically significant higher incidence of seizures in the winter days (p-value: 0.001) and in days with lower daylight duration (10.8 vs. 12.7 h; p-value: 0.0001). With the exception of humidity, these findings remained true when analyzing the subgroup of patients with previous seizures, but there was no significant difference in the subgroup of first unprovoked seizures. Conclusions: Our results support the possible influence of the weather on seizure frequency in the overall admissions of the emergency department of a tertiary hospital. In particular, these findings suggest that winter conditions, such as, lower ambient temperatures, higher atmospheric pressure, higher humidity, and reduced sunlight exposure, may have impact in the occurrence of higher incidence of seizures in patients with epilepsy.

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Weather as a risk factor for epileptic seizures: A case‐crossover study

Cited by 56 publications

References 40 publications

The effect of atmospheric pressure on frequency and patient's subjective perception of epileptic seizure severity

The effect of atmospheric pressure on frequency and patient's subjective perception of epileptic seizure severity

Critical slowing as a biomarker for seizure susceptibility

Influence of weather on seizure frequency — Clinical experience in the emergency room of a tertiary hospital

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