Changes of interictal epileptiform discharges during medication withdrawal and seizures: A scalp EEG marker of epileptogenicity.
Clin Neurophysiol Pract
; 7: 279-284, 2022.
Article
in En
| MEDLINE
| ID: mdl-36312513
ABSTRACT
Objective:
To determine the influence of antiseizure medication (ASM) withdrawal on interictal epileptogenic discharges (IEDs) in scalp-EEG and seizure propensity.Methods:
We included 35 adult unifocal epilepsy patients admitted for presurgical evaluation in the EEG and Epilepsy Unit of Geneva between 2016 and 2020, monitored for at least 5â¯days. ASM was individually tapered down, and automated IED detection was performed using Epilog PreOp (Epilog NV, Belgium, Ghent). We compared spike rate per hour (SR) at day 1 when patients were on full medication (baseline) with SR at the day with the lowest dose of medication. To determine possible peri-ictal changes of SR, we compared SR 8â¯h before and after a seizure with the SR at the same time of the baseline day.Results:
Our results showed a significant increase in spiking activity in the day of lowest drug load if compared to spike rate at day on full medication (pâ¯<â¯0.001). The total amount of spikes during 24â¯h correlated significantly with seizure occurrence (pâ¯<â¯0.0001). We also revealed significant increase in peri-ictal SR, in particular 2-4â¯h preceding a seizure (pâ¯=â¯0.05) extending up to 3â¯h after the seizure (pâ¯=â¯0.03) with a short decrease just before seizure occurrence.Conclusions:
Our results suggest that SR increases with medication withdrawal and particularly before and after seizures. There is a complex pattern of increase and decrease around seizure onset which explains divergent results in previous studies.Significance:
Precise spike counting at similar circadian periods for a patient could help to determine the risk of seizure occurrence in a personalized fashion.
Full text:
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Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Clin Neurophysiol Pract
Year:
2022
Document type:
Article
Affiliation country: