Prognostic Value of Generalized Polyspike Trains and Prolonged Epileptiform EEG Runs

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

INTRODUCTION: A considerable proportion of patients with genetic/idiopathic generalized epilepsy (IGE) suffer from persistent seizures. In this study, it was questioned if generalized polyspike trains (GPT) or prolonged epileptiform EEG runs allow identification of difficult-to-treat patients in a first seizure clinic setting or after recurrent seizures.

METHODS: The first routine outpatient EEGs from untreated patients (later diagnosed with IGE) and routine EEGs from IGE patients with persistent seizures despite medical treatment were analyzed. Seizure outcome and clinical characteristics were retrospectively assessed based on the patients' records.

RESULTS: In routine EEGs recorded after first seizure in untreated patients (n = 79), the prevalence of GPT (n = 1; 1.3%) and prolonged epileptiform EEG runs (n = 13; 16.5%) was low. At follow-up, 24 patients (30.4%) were not seizure free, and 3 (3.8%) of them developed drug-resistant IGE. None of the interictal discharges studied was associated with long-term seizure outcome. Treated IGE patients with recurrent seizures (n = 69) had a similar prevalence of GPT (n = 3; 4.3%) and prolonged epileptiform EEG runs (n = 7; 10.1%). At follow-up, 42 patients (60.8%) suffered persistent seizures, and 18 (26%) were drug resistant. Generalized polyspike train and prolonged epileptiform EEG runs had a higher prevalence in patients with drug-resistant epilepsy (GPT: 11.1% vs. 2%; P = 0.1; prolonged epileptiform EEG runs: 27.8% vs. 3.9%; P = 0.004) and persistent seizures (GPT: 7.1% vs. 0%; P = 0.16; prolonged epileptiform EEG runs: 16.7% vs. 0%; P = 0.03) as compared with nonresistant patients.

CONCLUSIONS: Generalized polyspike train and prolonged epileptiform EEG runs were associated with persistent seizures and drug-resistant IGE, but the overall prevalence was low. In a first seizure clinic setting, the diagnostic value of these biomarkers was limited.

Original languageEnglish
JournalJournal of Clinical Neurophysiology
ISSN0736-0258
DOIs
Publication statusE-pub ahead of print - 24. Dec 2019

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Electroencephalography
Pharmaceutical Preparations
Idiopathic Generalized Epilepsy
Outpatients

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@article{a1e06e08b4aa4fa2a96aa89776fe4342,
title = "Prognostic Value of Generalized Polyspike Trains and Prolonged Epileptiform EEG Runs",
abstract = "INTRODUCTION: A considerable proportion of patients with genetic/idiopathic generalized epilepsy (IGE) suffer from persistent seizures. In this study, it was questioned if generalized polyspike trains (GPT) or prolonged epileptiform EEG runs allow identification of difficult-to-treat patients in a first seizure clinic setting or after recurrent seizures.METHODS: The first routine outpatient EEGs from untreated patients (later diagnosed with IGE) and routine EEGs from IGE patients with persistent seizures despite medical treatment were analyzed. Seizure outcome and clinical characteristics were retrospectively assessed based on the patients' records.RESULTS: In routine EEGs recorded after first seizure in untreated patients (n = 79), the prevalence of GPT (n = 1; 1.3{\%}) and prolonged epileptiform EEG runs (n = 13; 16.5{\%}) was low. At follow-up, 24 patients (30.4{\%}) were not seizure free, and 3 (3.8{\%}) of them developed drug-resistant IGE. None of the interictal discharges studied was associated with long-term seizure outcome. Treated IGE patients with recurrent seizures (n = 69) had a similar prevalence of GPT (n = 3; 4.3{\%}) and prolonged epileptiform EEG runs (n = 7; 10.1{\%}). At follow-up, 42 patients (60.8{\%}) suffered persistent seizures, and 18 (26{\%}) were drug resistant. Generalized polyspike train and prolonged epileptiform EEG runs had a higher prevalence in patients with drug-resistant epilepsy (GPT: 11.1{\%} vs. 2{\%}; P = 0.1; prolonged epileptiform EEG runs: 27.8{\%} vs. 3.9{\%}; P = 0.004) and persistent seizures (GPT: 7.1{\%} vs. 0{\%}; P = 0.16; prolonged epileptiform EEG runs: 16.7{\%} vs. 0{\%}; P = 0.03) as compared with nonresistant patients.CONCLUSIONS: Generalized polyspike train and prolonged epileptiform EEG runs were associated with persistent seizures and drug-resistant IGE, but the overall prevalence was low. In a first seizure clinic setting, the diagnostic value of these biomarkers was limited.",
author = "Jensen, {Camilla Dyremose} and Joanna Gesche and Thomas Kr{\o}ig{\aa}rd and Beier, {Christoph P}",
year = "2019",
month = "12",
day = "24",
doi = "10.1097/WNP.0000000000000679",
language = "English",
journal = "Journal of Clinical Neurophysiology",
issn = "0736-0258",
publisher = "Lippincott Williams & Wilkins",

}

Prognostic Value of Generalized Polyspike Trains and Prolonged Epileptiform EEG Runs. / Jensen, Camilla Dyremose; Gesche, Joanna; Krøigård, Thomas; Beier, Christoph P.

In: Journal of Clinical Neurophysiology, 24.12.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Prognostic Value of Generalized Polyspike Trains and Prolonged Epileptiform EEG Runs

AU - Jensen, Camilla Dyremose

AU - Gesche, Joanna

AU - Krøigård, Thomas

AU - Beier, Christoph P

PY - 2019/12/24

Y1 - 2019/12/24

N2 - INTRODUCTION: A considerable proportion of patients with genetic/idiopathic generalized epilepsy (IGE) suffer from persistent seizures. In this study, it was questioned if generalized polyspike trains (GPT) or prolonged epileptiform EEG runs allow identification of difficult-to-treat patients in a first seizure clinic setting or after recurrent seizures.METHODS: The first routine outpatient EEGs from untreated patients (later diagnosed with IGE) and routine EEGs from IGE patients with persistent seizures despite medical treatment were analyzed. Seizure outcome and clinical characteristics were retrospectively assessed based on the patients' records.RESULTS: In routine EEGs recorded after first seizure in untreated patients (n = 79), the prevalence of GPT (n = 1; 1.3%) and prolonged epileptiform EEG runs (n = 13; 16.5%) was low. At follow-up, 24 patients (30.4%) were not seizure free, and 3 (3.8%) of them developed drug-resistant IGE. None of the interictal discharges studied was associated with long-term seizure outcome. Treated IGE patients with recurrent seizures (n = 69) had a similar prevalence of GPT (n = 3; 4.3%) and prolonged epileptiform EEG runs (n = 7; 10.1%). At follow-up, 42 patients (60.8%) suffered persistent seizures, and 18 (26%) were drug resistant. Generalized polyspike train and prolonged epileptiform EEG runs had a higher prevalence in patients with drug-resistant epilepsy (GPT: 11.1% vs. 2%; P = 0.1; prolonged epileptiform EEG runs: 27.8% vs. 3.9%; P = 0.004) and persistent seizures (GPT: 7.1% vs. 0%; P = 0.16; prolonged epileptiform EEG runs: 16.7% vs. 0%; P = 0.03) as compared with nonresistant patients.CONCLUSIONS: Generalized polyspike train and prolonged epileptiform EEG runs were associated with persistent seizures and drug-resistant IGE, but the overall prevalence was low. In a first seizure clinic setting, the diagnostic value of these biomarkers was limited.

AB - INTRODUCTION: A considerable proportion of patients with genetic/idiopathic generalized epilepsy (IGE) suffer from persistent seizures. In this study, it was questioned if generalized polyspike trains (GPT) or prolonged epileptiform EEG runs allow identification of difficult-to-treat patients in a first seizure clinic setting or after recurrent seizures.METHODS: The first routine outpatient EEGs from untreated patients (later diagnosed with IGE) and routine EEGs from IGE patients with persistent seizures despite medical treatment were analyzed. Seizure outcome and clinical characteristics were retrospectively assessed based on the patients' records.RESULTS: In routine EEGs recorded after first seizure in untreated patients (n = 79), the prevalence of GPT (n = 1; 1.3%) and prolonged epileptiform EEG runs (n = 13; 16.5%) was low. At follow-up, 24 patients (30.4%) were not seizure free, and 3 (3.8%) of them developed drug-resistant IGE. None of the interictal discharges studied was associated with long-term seizure outcome. Treated IGE patients with recurrent seizures (n = 69) had a similar prevalence of GPT (n = 3; 4.3%) and prolonged epileptiform EEG runs (n = 7; 10.1%). At follow-up, 42 patients (60.8%) suffered persistent seizures, and 18 (26%) were drug resistant. Generalized polyspike train and prolonged epileptiform EEG runs had a higher prevalence in patients with drug-resistant epilepsy (GPT: 11.1% vs. 2%; P = 0.1; prolonged epileptiform EEG runs: 27.8% vs. 3.9%; P = 0.004) and persistent seizures (GPT: 7.1% vs. 0%; P = 0.16; prolonged epileptiform EEG runs: 16.7% vs. 0%; P = 0.03) as compared with nonresistant patients.CONCLUSIONS: Generalized polyspike train and prolonged epileptiform EEG runs were associated with persistent seizures and drug-resistant IGE, but the overall prevalence was low. In a first seizure clinic setting, the diagnostic value of these biomarkers was limited.

U2 - 10.1097/WNP.0000000000000679

DO - 10.1097/WNP.0000000000000679

M3 - Journal article

C2 - 31880591

JO - Journal of Clinical Neurophysiology

JF - Journal of Clinical Neurophysiology

SN - 0736-0258

ER -