Bimodal ultradian seizure periodicity in human mesial temporal lobe epilepsy  Matthew Karafin, Erik K. St. Louis, M. Bridget Zimmerman, Jon David Sparks, Mark A. Granner  Seizure - European Journal of Epilepsy  Volume 19, Issue 6, Pages 347-351 (July 2010) DOI: 10.1016/j.seizure.2010.05.005 Copyright © 2010 British Epilepsy Association Terms and Conditions

Fig. 1 Seizure counts combined for all mTLE subjects (1-h interval). Peak seizure frequency occurred between 0600–0800 and 1500–1700. Seizure - European Journal of Epilepsy 2010 19, 347-351DOI: (10.1016/j.seizure.2010.05.005) Copyright © 2010 British Epilepsy Association Terms and Conditions

Fig. 2 Seizure frequency for all mTLE subjects (3-h intervals). Peak seizure frequency occurred between 0600–0800 (0.242, 95% CI 0.182, 0.322) and 1500–1700 (0.200, 95% CI 0.144, 0.252). Seizure - European Journal of Epilepsy 2010 19, 347-351DOI: (10.1016/j.seizure.2010.05.005) Copyright © 2010 British Epilepsy Association Terms and Conditions

Fig. 3 Cosinor model of peak seizure frequency. Cosinor analysis demonstrated a bimodal peak in seizure frequency in mTLE. Seizure - European Journal of Epilepsy 2010 19, 347-351DOI: (10.1016/j.seizure.2010.05.005) Copyright © 2010 British Epilepsy Association Terms and Conditions

Fig. 4 Seizure frequency by gender. Females had a higher mean seizure frequency during the afternoon peak hours of 1500–1700 (0.22, 95% CI 0.17, 0.34) than males (0.16, 95% CI 0.08, 0.29), but the overlapping confidence intervals during this timeframe indicate the difference was not statistically significant. Seizure - European Journal of Epilepsy 2010 19, 347-351DOI: (10.1016/j.seizure.2010.05.005) Copyright © 2010 British Epilepsy Association Terms and Conditions

Fig. 5 Seizure frequency by age. Age range of 30–39 had the most robust bimodal ultradian seizure frequency peaks, but the patterns of this group were not statistically different from those under 30 or over 40 given overlapping confidence intervals. Seizure - European Journal of Epilepsy 2010 19, 347-351DOI: (10.1016/j.seizure.2010.05.005) Copyright © 2010 British Epilepsy Association Terms and Conditions

Fig. 6 Seizure frequency by lateralization of seizure focus. No significant difference in seizure frequencies was seen for left or right mTLE subjects. Seizure - European Journal of Epilepsy 2010 19, 347-351DOI: (10.1016/j.seizure.2010.05.005) Copyright © 2010 British Epilepsy Association Terms and Conditions