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Clinical, EEG Factors May Predict Treatment Response in Epilepsy

Certain clinical and EEG characteristics may predict resistance to antiseizure medication in patients with idiopathic generalized epilepsy

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THURSDAY, Nov. 4, 2021 (HealthDay News) -- Catamenial epilepsy, some seizure-type combinations, and specific electroencephalography (EEG) characteristics are associated with antiseizure medication (ASM)-resistant idiopathic generalized epilepsy (IGE), according to a study published online Oct. 27 in Epilepsia.

Brad K. Kamitaki, from Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues assessed clinical and EEG characteristics to identify those that differentiate ASM-resistant versus ASM-responsive patients with IGE. The analysis included 118 ASM-resistant cases and 114 ASM-responsive controls with IGE treated at five epilepsy centers in the United States and Australia between 2002 and 2018.

The researchers found that catamenial epilepsy was associated with ASM-resistant IGE (odds ratio [OR], 3.53) in an adjusted analysis. ASM resistance was also associated with certain seizure-type combinations (absence, myoclonic, and generalized tonic-clonic seizures [OR, 7.06]; absence and generalized tonic-clonic seizures [OR, 4.45]). Further, EEG markers of increased generalized spike-wave discharges in sleep (GSWs; OR, 3.43 for frequent; OR, 7.21 for abundant discharges in sleep) and the presence of generalized polyspike trains (GPTs; OR, 5.49) were associated with ASM resistance.

"Obtaining prolonged EEG studies to record the burden of GSWs in sleep and assessing for the presence of GPTs may provide additional predictive value," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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