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Epilepsy is recognised as a dynamic disease, where both seizuresusceptibility and seizure characteristics themselves change over time.Specifically, we recently quantified the variable electrographicspatio-temporal seizure evolutions that exist within individual patients. Thisvariability appears to follow subject-specific circadian, or longer, timescalemodulations. It is therefore important to know whether continuously-recordedinterictal iEEG features can capture signatures of these modulations overdifferent timescales.  In this work, we analyse continuous intracranial electroencephalographic(iEEG) recordings from video-telemetry units and find fluctuations in iEEG bandpower over timescales ranging from minutes up to twelve days.  As expected and in agreement with previous studies, we find that all subjectsshow a circadian fluctuation in their iEEG band power. We additionally findother fluctuations of similar magnitude on subject-specific timescales.Importantly, we find that a combination of these fluctuations on differenttimescales can explain changes in seizure evolutions in most subjects abovechance level.  These results suggest that subject-specific fluctuations in iEEG band powerover timescales of minutes to days may serve as markers of seizure modulatingprocesses. We hope that future work can link these detected fluctuations totheir biological driver(s). There is a critical need to better understandseizure modulating processes, as this will enable the development of noveltreatment strategies that could minimise the seizure spread, duration, orseverity and therefore the clinical impact of seizures.

Fluctuations in EEG band power at subject-specific timescales over minutes to days explain changes in seizure evolutions