The clinical value of long - term electroencephalogram (EEG) in seizure - free populations: implications from a cross-sectional study

Tang Xinghua,Pu Zheng,Wei Yarong,Fan Qinyi,Liu Zhenguo,Li Lin

doi:10.1186/s12883-019-1521-1

Tang Xinghua, Pu Zheng + Show 4 more

Open Access

https://doi.org/10.1186/s12883-019-1521-1

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Journal: BMC Neurology	Publication Date: Mar 12, 2020
Citations: 3	License type: open-access

Affiliation: Shanghai Jiao Tong University, XinHua Hospital

Abstract

BackgroudThis study aimed to explore the clinical value of long - term electroencephalogram (LTM EEG) in seizure-free individuals taking antiepileptic drugs (AEDs) for more than 2 years. We try to look for clinical factors associated with epileptiform activity on LTM EEG in seizure free patients. We hope that the detection of epileptiform activity by the LTM EEG recording can develop the better treatment strategy.MethodsThe LTM EEG recordings of 770 individuals with a definite diagnosis of epilepsy were assessed. Two hundred sixty-two individuals accorded with the inclusion criteria and exclusion criteria. We collect the demographic and clinical information and LTM EEG data of these 262 individuals. We analysed the data by one-way analysis of variance and Cox proportional hazards models.ResultsWe found that more epileptiform activity were found with LTM EEG recording than regular EEG recording in seizure-free individuals. We found several clinical factors could be associated with epileptiform activity on LTM EEG in seizure free patients by a one-way analysis: symptomatic or cryptogenic epilepsy [hazard ratio (HR) = 2.6], history of cerebral trauma (HR = 7.5), and abnormal imaging findings (HR = 3.1). The following factors suggested a correlation between history of cerebral trauma (HR = 2.4) and history of cerebral surgery (HR = 3.4) with epileptiform activity on LTM EEG presentation by multivariate logistic regression analysis.ConclusionsThe study indicated a correlation of a number of factors with abnormal LTM EEG presentation: symptomatic or cryptogenic epilepsy, history of cerebral trauma, history of cerebral surgery, and abnormal imaging findings. The LTM EEG recording may help find epileptiform activity in high risk seizure-free individuals. The individuals need be reevaluated the therapeutic strateagies, and increase the hope to reach real seizure-free.

Highlights

Epilepsy is a chronic disease need long-term management
We found that more epileptiform activity were found with long - term electroencephalogram (LTM EEG) recording than regular EEG recording in seizure-free individuals
The present study demonstrated that seizure-free patients with symptomatic epilepsy or abnormal imaging findings might have abnormal LTM EEG presentation

Summary

Introduction

Epilepsy is a chronic disease need long-term management. The probability of remaining seizure-free after treatment discontinuation is about 70% at 2 years [1]. The LTM EEG recording includes ambulatory EEG (AEEG) and video LTM EEG (VEEG). They have a higher sensitivity and lower false-negative rate compared with regular EEG recording. The LTM EEG help to detect subclinical episode, improve the diagnosis rate of epilepsy and obtain the real world evidence. It is necessary to follow up LTM EEG recording during longterm epilepsy management process and adopt an appropriate drug withdrawal scheme for patients. The role of LTM EEG recording in determining AED treatment or predicting the relapse risk has been evaluated in multiple studies [10, 11]. There have few researches been done on the risk factors of LTM EEG recording in seizure-free patients. One study showed female, delayed therapy, longer duration of intractability may have the relationship with abnormal ambulatory EEG presentation [12]

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