Evidence about the interaction between circadian rhythms (CR) and epilepsy has been expanded with the application of advanced detection technology. An adequate understanding of how circadian system and epilepsy interact with each other could contribute to more accurate seizure prediction as well as rapid development of potential treatment timed to specific phases of CR. In this review, we present the reciprocal relationship between CR and epileptic activities from aspects of sleep effect, genetic modulation and brain biochemistry. It has been found that sleep-wake patterns, circadian timing systems and multidien rhythms have essential roles in seizure activities and interictal epileptiform discharge (IED). For instance, specific distribution patterns of seizures and IED have been reported, i.e., lighter non-rapid eye movement (NREM) sleep stage (stage 2) induces seizures while deeper NREM sleep stage (stage 3) activates IEDs. Furthermore, the epilepsy type, seizure type and seizure onset zone can significantly affect the rhythms of seizure occurrence. Apart from the common seizure types, several specific epilepsy syndromes also have a close correlation with sleep-wakefulness patterns. Sleep influences the epilepsy rhythm, and conversely, epilepsy alters the sleep rhythm through multiple pathways. Clock genes accompanied by two feedback loops of regulation have an important role in cortical excitability and seizure occurrence, which may be involved in the mTORopathy. The suprachiasmatic nuclei (SCN) has a rhythm of melatonin and cortisol secretion under the circadian pattern, and then these hormones can feed back into a central oscillator to affect the SCN-dependent rhythms, leading to variable but prominent influence on epilepsy. Furthermore, we discuss the precise predictive algorithms and chronotherapy strategies based on different temporal patterns of seizure occurrence for patients with epilepsy, which may offer a valuable indication for non-invasive closed-loop treatment system. Optimization of the time and dose of antiseizure medications, and resynchronization of disturbed CR (by hormone therapy, light exposure, ketogenic diet, novel small molecules) would be beneficial for epileptic patients in the future. Before formal clinical practice, future large-scale studies are urgently needed to assist prediction and treatment of circadian seizure activities and address unsolved restrictions.

随着先进检测技术的应用，有关昼夜节律 (CR) 与癫痫之间相互作用的证据已经得到扩展。充分了解昼夜节律系统和癫痫如何相互作用有助于更准确地预测癫痫发作以及快速开发针对 CR 特定阶段的潜在治疗。在这篇综述中，我们从睡眠效应、基因调节和脑生化方面介绍了 CR 与癫痫活动之间的相互关系。已经发现，睡眠-觉醒模式、昼夜节律系统和多节律在癫痫发作活动和发作间期癫痫样放电 (IED) 中具有重要作用。例如，已经报告了缉获量和简易爆炸装置的特定分布模式，即，较轻的非快速眼动 (NREM) 睡眠阶段（第 2 阶段）会诱发癫痫发作，而较深的 NREM 睡眠阶段（第 3 阶段）会激活 IED。此外，癫痫类型、发作类型和发作起病区可显着影响发作发生的节律。除了常见的癫痫发作类型外，几种特定的癫痫综合征也与睡眠-觉醒模式密切相关。睡眠影响癫痫节律，相反，癫痫通过多种途径改变睡眠节律。伴随着两个调节反馈回路的时钟基因在皮质兴奋性和癫痫发作发生中具有重要作用，这可能与mTORopathy有关。视交叉上核（SCN）在昼夜节律模式下具有褪黑激素和皮质醇分泌的节律，然后这些激素可以反馈到一个中枢振荡器，影响 SCN 依赖性节律，从而对癫痫产生不同但显着的影响。此外，我们讨论了基于癫痫患者不同癫痫发作时间模式的精确预测算法和时间治疗策略，这可能为无创闭环治疗系统提供有价值的指征。优化抗癫痫药物的时间和剂量，以及重新同步受干扰的 CR（通过激素治疗、光照、生酮饮食、新型小分子）将在未来对癫痫患者有益。在正式临床实践之前，迫切需要未来的大规模研究来帮助预测和治疗昼夜节律癫痫活动并解决未解决的限制。