{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:53:09Z","timestamp":1783698789653,"version":"3.55.0"},"reference-count":81,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T00:00:00Z","timestamp":1684108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Major objectives of this work were to: (1) substantiate the 24\u2010hour pattern in the occurrence of childhood febrile seizures (CFSs) by a novel time series meta\u2010analysis of past reported time\u2010of\u2010day data and (2) discuss its potential circadian rhythm\u2010dependencies. Comprehensive search of the published literature retrieved eight articles that met inclusion criteria. Three investigations were conducted in Iran, two in Japan, and one each in Finland, Italy, and South Korea, representing a total of 2461 mostly simple febrile seizures of children who were on average about 2\u2009years of age. Population\u2010mean cosinor analysis validated (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) a 24\u2010hour pattern in the onset of CFSs, with an approximate four\u2010fold difference in the proportion of children expressing seizures at its peak at 18:04\u2009h (95% confidence interval: 16:40\u201319:07\u2009h) vs trough at 06:00\u2009h, in the absence of meaningful time\u2010of\u2010day differences in mean body temeprarure. The CFS time\u2010of\u2010day pattern likely derives from the actions of multiple circadian rhythms, particularly the cytokines that comprise the pyrogenic inflammatory pathway and melatonin that influences the excitation level of central neurons and helps regulate body temperature. Past laboratory animal and patient investigations document that the vulnerability to a seizure by a provoking trigger of the same intensity is not the same but different in a predictable\u2010in\u2010time manner during the 24\u2009h as a circadian susceptibility\/resistance rhythm. Knowledge of the marked disparity in the time\u2010of\u2010day risk of CFSs can be translated into improved prevention, particularly during the late afternoon and early evening when highest, through proper timing of prophylactic interventions.<\/jats:p>","DOI":"10.1111\/epi.17639","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T12:54:08Z","timestamp":1683118448000},"page":"1739-1749","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Twenty\u2010four hour pattern of childhood febrile seizures substantiated by time series meta\u2010analysis: Circadian medicine perspectives"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9184-0739","authenticated-orcid":false,"given":"Michael H.","family":"Smolensky","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Cockrell School of Engineering The University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2836-6544","authenticated-orcid":false,"given":"Ami P.","family":"Shah","sequence":"additional","affiliation":[{"name":"UMC Children's Hospital of Nevada University of Nevada\u2010Las Vegas Kirk Kerkorian School of Medicine  Las Vegas Nevada USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8652-0124","authenticated-orcid":false,"given":"Jos\u00e9 R.","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Bioengineering &amp; Chronobiology Laboratories, Atlantic Research Center for Telecommunication Technologies University of Vigo  Vigo Spain"},{"name":"Bioengineering &amp; Chronobiology Research Group Galicia Sur Health Research Institute (IIS Galicia Sur), Galician Health Service  Vigo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4267-0673","authenticated-orcid":false,"given":"Linda","family":"Sackett\u2010Lundeen","sequence":"additional","affiliation":[{"name":"American Association for Medical Chronobiology &amp; Chronotherapeutics  Roseville Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8853-5901","authenticated-orcid":false,"given":"Ramon C.","family":"Hermida","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Cockrell School of Engineering The University of Texas at Austin  Austin Texas USA"},{"name":"Bioengineering &amp; Chronobiology Laboratories, Atlantic Research Center for Telecommunication Technologies University of Vigo  Vigo Spain"},{"name":"Bioengineering &amp; Chronobiology Research Group Galicia Sur Health Research Institute (IIS Galicia Sur), Galician Health Service  Vigo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.801321"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.7573\/dic.212536"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.31128\/AJGP-02-20-5236"},{"key":"e_1_2_10_5_1","first-page":"328","article-title":"Recherches statistics pour server \u00e1 l'historie de l' \u00e9pilepsie et hyst\u00e9rie","volume":"11","author":"Beau M","year":"1836","journal-title":"Arch Gen Med"},{"key":"e_1_2_10_6_1","volume-title":"Epilepsy and other convulsive diseases: their causes, symptoms and treatment","author":"Gowers WR","year":"1901"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)79288-9"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.87.5.789"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)41614-4"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.1958.11692235"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2009.01.020"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2012.03499.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjno-2021-000264"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.15844\/pedneurbriefs-29-4-4"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.06.079"},{"issue":"59","key":"e_1_2_10_16_1","first-page":"59","article-title":"Evaluation of seasonal variation and circadian rhythm of febrile seizures in children admitted to the pediatric ward of Rasoul\u2010e\u2010Akram hospital","volume":"15","author":"Khoda Panahandeh F","year":"2008","journal-title":"Razi J Med Sci"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2015.01.001"},{"issue":"3","key":"e_1_2_10_18_1","first-page":"27","article-title":"Circadian rhythm and the seasonal variation in childhood febrile seizure","volume":"11","author":"Sharafi R","year":"2017","journal-title":"Iran J Child Neurol"},{"issue":"4","key":"e_1_2_10_19_1","first-page":"1548","article-title":"Assessment of causative factors of febrile seizure related to a group of children in Iran","volume":"28","author":"Mohsenipour R","year":"2017","journal-title":"Biomed Res\u2010India"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2008.07.017"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.18203\/2349-3291.ijcp20202624"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2018.01.015"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2010.02.011"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.26815\/jkcns.2016.24.2.33"},{"issue":"367","key":"e_1_2_10_25_1","first-page":"431","article-title":"Chronobiological analysis techniques. Application to blood pressure","volume":"2009","author":"Fern\u00e1ndez JR","year":"1887","journal-title":"Philos Transact A Math Phys Eng Sci"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3109\/07420529209064552"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1081\/CBI-120021383"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.4.909"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2010.02554.x"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy263"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080376"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21909"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/jnr.21103"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-011-0564-0"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2005.11.023"},{"issue":"2","key":"e_1_2_10_36_1","first-page":"205","article-title":"Circadian rhythm in human nerve conduction velocity","volume":"7","author":"Ferrario VF","year":"1980","journal-title":"Chronobiologia"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-0102(03)00025-7"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-9384(01)00414-0"},{"issue":"2","key":"e_1_2_10_39_1","first-page":"129","article-title":"Feeling the heat: body temperature and the rate of subjective time, revisited","volume":"48","author":"Wearden JH","year":"1995","journal-title":"Q J Exp Psychol B"},{"issue":"1","key":"e_1_2_10_40_1","first-page":"42","article-title":"Effect of increased body temperature on the perception of time","volume":"23","author":"Alderson MJ","year":"1974","journal-title":"Nurs Res"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1086\/514520"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-8994(00)00234-4"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1086\/377101"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2005.00294.x"},{"key":"e_1_2_10_45_1","volume-title":"Introducing biological rhythms","author":"Koukkari WL","year":"2006"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1615\/CritRevImmunol.v37.i2\u20106.70"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749\u20106632.2009.05300.x"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/088307389801301007"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-985138"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2015.12.025"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1159\/000068571"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1053\/sper.2000.8594"},{"key":"e_1_2_10_53_1","first-page":"217","article-title":"The pineal gland in relation to growth and development in children","volume":"21","author":"Gupta D","year":"1986","journal-title":"J Neural Transm Suppl"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuchi.2015.03.002"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073809351315"},{"issue":"4","key":"e_1_2_10_56_1","first-page":"288","article-title":"Serum melatonin levels in children with epilepsy or febrile seizures (Chinese)","volume":"11","author":"Guo JF","year":"2009","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-017-0974-7"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-020-01756-x"},{"key":"e_1_2_10_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpi.12525"},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.14715\/cmb\/2017.63.11.3"},{"key":"e_1_2_10_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2015.11.004"},{"key":"e_1_2_10_62_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.75.2.447"},{"key":"e_1_2_10_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-079X.2007.00501.x"},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-013-2668-x"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1964.tb48193.x"},{"key":"e_1_2_10_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378-3782(94)90039-6"},{"key":"e_1_2_10_67_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.94.4.482"},{"key":"e_1_2_10_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/0163-7258(83)90011-6"},{"issue":"23","key":"e_1_2_10_69_1","first-page":"1014","article-title":"The circadian rhythm of body temperature is preserved during malarial fever","volume":"112","author":"Lell B","year":"2000","journal-title":"Wien Klin Wochenschr"},{"key":"e_1_2_10_70_1","volume-title":"Clinical methods: the history, physical, and laboratory examinations","author":"Del Bene VE","year":"1990"},{"key":"e_1_2_10_71_1","doi-asserted-by":"publisher","DOI":"10.1159\/000026344"},{"key":"e_1_2_10_72_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2011.02794.x"},{"key":"e_1_2_10_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2020.07.010"},{"key":"e_1_2_10_74_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2020.3.45215"},{"key":"e_1_2_10_75_1","doi-asserted-by":"publisher","DOI":"10.2486\/indhealth.SW-2"},{"key":"e_1_2_10_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2014.06.005"},{"key":"e_1_2_10_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2014.07.001"},{"key":"e_1_2_10_78_1","doi-asserted-by":"publisher","DOI":"10.3181\/00379727-88-21526"},{"key":"e_1_2_10_79_1","first-page":"67","article-title":"Twenty four hour susceptibility to audiogenic convulsions in several stocks of mice","volume":"14","author":"Halberg F","year":"1955","journal-title":"Fed Proc"},{"key":"e_1_2_10_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(84)91109-0"},{"key":"e_1_2_10_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/0014-4886(70)90051-8"},{"key":"e_1_2_10_82_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.5866"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.17639","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T22:26:30Z","timestamp":1692224790000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.17639"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,15]]},"references-count":81,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/epi.17639"],"URL":"https:\/\/doi.org\/10.1111\/epi.17639","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,15]]},"assertion":[{"value":"2023-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}