Prognostic value of EEG asymmetries for development of drug-resistance in drug-naïve patients with genetic generalized epilepsies.

Abstract

OBJECTIVE:

Previous studies based solely on visual EEG analysis reported equivocal results regarding an association of pharmaco-resistance with EEG asymmetries in genetic generalized epilepsies (GGE). We addressed this issue by applying both visual and quantitative methods to the pretreatment EEG of GGE patients.

METHODS:

Socio-demographic/disease characteristics and response to treatment/discontinuation trial for these patients were recorded at 6months and at last follow up. The first EEG was retrospectively, blindly, and visually assessed for focal slowing, focal discharges and also quantitatively analyzed for amplitude or latency asymmetries of generalized discharges. Association between these variables and development of drug-resistance was evaluated.

RESULTS:

Out of 51 subjects, 40% had some type of EEG asymmetry by visual, 37% by quantitative and 54% by combined analysis. Drug-resistance was identified in 52% of patients after 6months and in 24% at the end of the follow up period (∼4.2years). 27% of patients underwent a discontinuation trial; 43% unsuccessfully. There was no association between baseline EEG asymmetries of any type and refractoriness to medical therapy, regardless of analytical method used.

CONCLUSIONS:

In a carefully selected cohort of medication-naïve GGE patients, visual and quantitative asymmetries in the first EEG were not associated with the development of pharmaco-resistance.

SIGNIFICANCE:

These findings do not provide support for utilization of EEG asymmetries as a prognostic tool in GGE.

• Authors: Ioannis Karakis, Jay S Pathmanathan, Richard Chang, E Francis Cook, Sydney S Cash, Andrew J Cole
• Journal: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology (Clin Neurophysiol) Vol. 125 Issue 2 Pg. 263-9 (Feb 2014) ISSN: 1872-8952 [Electronic] Netherlands
• PMID: 24095154 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Anticonvulsants

Topics

• Adolescent
• Anticonvulsants (therapeutic use)
• Cerebral Cortex (physiopathology)
• Child
• Drug Resistance (physiology)
• Electroencephalography
• Epilepsy, Generalized (drug therapy, genetics, physiopathology)
• Female
• Humans
• Male
• Prognosis
• Retrospective Studies
• Treatment Failure