Ambulatory and conventional EEC: Prognostic value in the withdrawal of antiepileptic drugs

M. T. Faedda, L. Fusco, A. T. Giallonardo, C. Lani, A. Marchetti, M. Manfredi

Research output: Contribution to journalArticle

Abstract

Objective Statistical information regarding the probability of relapse in the various forms of epilepsy is crucial to the decision of withdrawing antiepileptic drugs (AED). The prognostic value of the electroencephalogram (EEC) is still subject of controversy. The purpose of this study was to assess anticipatory information provided by EEC monitoring of epileptiform abnormalities before and during withdrawal of AED, and to evaluate the respective value of ambulatory (AEEG) and conventional EEC (CEEG). Materials and methods The requirements for admission to the study were a positive diagnosis of epilepsy and the absence of seizures for at least three years. Fifty-three subjects aged 9 to 64 years were selected from the outpatient population of the Epilepsy Centre of the Department of Neurological Sciences of "La Sapienza" University in Rome. Twenty-four had a diagnosis of generalized epilepsy (GE) and 29 of partial epilepsy (PE). The procedure consisted in withdrawal from therapy in 9 months by reducing the dose by one-fourth every 3 months, and in assessing CEEG, 24-hour AEEG and the plasma level of the AED at the following intervals: 0, 3 months, 6 months, 9 months and 12 months (only for the EEC). The CEEG and AEEG analysis, with quantification of abnormalities, was carried out blindly after the conclusion of the study. Results Forty-three patients concluded the study, 20 with GE and 23 with PE. Twenty-one patients (48.8%) showed a relapse, 9 with GE (45%) and 12 with PE (52%). Of the 9 patients with GE who suffered a relapse, 6 patients underwent the recurrence of seizures during the reduction of therapy and 3 patients after the conclusion of AED withdrawal. Of the 12 patients with PE who relapsed, 3 (25%) underwent relapses during the reduction and 9 (75%) after the conclusion of withdrawal. AEEG showed a better prognostic value than CEEG (/>=0.029) since 13 out of 21 (61.9% ) patients who relapsed showed worsening of AEEG in the course of withdrawal compared with 4 ( 19%) who showed worsening of CEEG. The results are particularly significant for PE (8 AEEG worsening out of 12, compared with 2 CEEG worsening: />=0.0018). Conclusion Better anticipatory information provided by AEEG with respect to CEEG depends on two reasons, the long duration of recording and the possibility of monitoring an entire sleep-waking cycle.

Original languageEnglish
Pages (from-to)347
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume20
Issue number5
Publication statusPublished - 1999

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Anticonvulsants
Electroencephalography
Partial Epilepsy
Generalized Epilepsy
Recurrence
Epilepsy
Absence Epilepsy
Polysomnography
Seizures
Outpatients
Therapeutics
Population

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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Faedda, M. T., Fusco, L., Giallonardo, A. T., Lani, C., Marchetti, A., & Manfredi, M. (1999). Ambulatory and conventional EEC: Prognostic value in the withdrawal of antiepileptic drugs. Italian Journal of Neurological Sciences, 20(5), 347.

Ambulatory and conventional EEC : Prognostic value in the withdrawal of antiepileptic drugs. / Faedda, M. T.; Fusco, L.; Giallonardo, A. T.; Lani, C.; Marchetti, A.; Manfredi, M.

In: Italian Journal of Neurological Sciences, Vol. 20, No. 5, 1999, p. 347.

Research output: Contribution to journalArticle

Faedda, MT, Fusco, L, Giallonardo, AT, Lani, C, Marchetti, A & Manfredi, M 1999, 'Ambulatory and conventional EEC: Prognostic value in the withdrawal of antiepileptic drugs', Italian Journal of Neurological Sciences, vol. 20, no. 5, pp. 347.
Faedda, M. T. ; Fusco, L. ; Giallonardo, A. T. ; Lani, C. ; Marchetti, A. ; Manfredi, M. / Ambulatory and conventional EEC : Prognostic value in the withdrawal of antiepileptic drugs. In: Italian Journal of Neurological Sciences. 1999 ; Vol. 20, No. 5. pp. 347.
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abstract = "Objective Statistical information regarding the probability of relapse in the various forms of epilepsy is crucial to the decision of withdrawing antiepileptic drugs (AED). The prognostic value of the electroencephalogram (EEC) is still subject of controversy. The purpose of this study was to assess anticipatory information provided by EEC monitoring of epileptiform abnormalities before and during withdrawal of AED, and to evaluate the respective value of ambulatory (AEEG) and conventional EEC (CEEG). Materials and methods The requirements for admission to the study were a positive diagnosis of epilepsy and the absence of seizures for at least three years. Fifty-three subjects aged 9 to 64 years were selected from the outpatient population of the Epilepsy Centre of the Department of Neurological Sciences of {"}La Sapienza{"} University in Rome. Twenty-four had a diagnosis of generalized epilepsy (GE) and 29 of partial epilepsy (PE). The procedure consisted in withdrawal from therapy in 9 months by reducing the dose by one-fourth every 3 months, and in assessing CEEG, 24-hour AEEG and the plasma level of the AED at the following intervals: 0, 3 months, 6 months, 9 months and 12 months (only for the EEC). The CEEG and AEEG analysis, with quantification of abnormalities, was carried out blindly after the conclusion of the study. Results Forty-three patients concluded the study, 20 with GE and 23 with PE. Twenty-one patients (48.8{\%}) showed a relapse, 9 with GE (45{\%}) and 12 with PE (52{\%}). Of the 9 patients with GE who suffered a relapse, 6 patients underwent the recurrence of seizures during the reduction of therapy and 3 patients after the conclusion of AED withdrawal. Of the 12 patients with PE who relapsed, 3 (25{\%}) underwent relapses during the reduction and 9 (75{\%}) after the conclusion of withdrawal. AEEG showed a better prognostic value than CEEG (/>=0.029) since 13 out of 21 (61.9{\%} ) patients who relapsed showed worsening of AEEG in the course of withdrawal compared with 4 ( 19{\%}) who showed worsening of CEEG. The results are particularly significant for PE (8 AEEG worsening out of 12, compared with 2 CEEG worsening: />=0.0018). Conclusion Better anticipatory information provided by AEEG with respect to CEEG depends on two reasons, the long duration of recording and the possibility of monitoring an entire sleep-waking cycle.",
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T2 - Prognostic value in the withdrawal of antiepileptic drugs

AU - Faedda, M. T.

AU - Fusco, L.

AU - Giallonardo, A. T.

AU - Lani, C.

AU - Marchetti, A.

AU - Manfredi, M.

PY - 1999

Y1 - 1999

N2 - Objective Statistical information regarding the probability of relapse in the various forms of epilepsy is crucial to the decision of withdrawing antiepileptic drugs (AED). The prognostic value of the electroencephalogram (EEC) is still subject of controversy. The purpose of this study was to assess anticipatory information provided by EEC monitoring of epileptiform abnormalities before and during withdrawal of AED, and to evaluate the respective value of ambulatory (AEEG) and conventional EEC (CEEG). Materials and methods The requirements for admission to the study were a positive diagnosis of epilepsy and the absence of seizures for at least three years. Fifty-three subjects aged 9 to 64 years were selected from the outpatient population of the Epilepsy Centre of the Department of Neurological Sciences of "La Sapienza" University in Rome. Twenty-four had a diagnosis of generalized epilepsy (GE) and 29 of partial epilepsy (PE). The procedure consisted in withdrawal from therapy in 9 months by reducing the dose by one-fourth every 3 months, and in assessing CEEG, 24-hour AEEG and the plasma level of the AED at the following intervals: 0, 3 months, 6 months, 9 months and 12 months (only for the EEC). The CEEG and AEEG analysis, with quantification of abnormalities, was carried out blindly after the conclusion of the study. Results Forty-three patients concluded the study, 20 with GE and 23 with PE. Twenty-one patients (48.8%) showed a relapse, 9 with GE (45%) and 12 with PE (52%). Of the 9 patients with GE who suffered a relapse, 6 patients underwent the recurrence of seizures during the reduction of therapy and 3 patients after the conclusion of AED withdrawal. Of the 12 patients with PE who relapsed, 3 (25%) underwent relapses during the reduction and 9 (75%) after the conclusion of withdrawal. AEEG showed a better prognostic value than CEEG (/>=0.029) since 13 out of 21 (61.9% ) patients who relapsed showed worsening of AEEG in the course of withdrawal compared with 4 ( 19%) who showed worsening of CEEG. The results are particularly significant for PE (8 AEEG worsening out of 12, compared with 2 CEEG worsening: />=0.0018). Conclusion Better anticipatory information provided by AEEG with respect to CEEG depends on two reasons, the long duration of recording and the possibility of monitoring an entire sleep-waking cycle.

AB - Objective Statistical information regarding the probability of relapse in the various forms of epilepsy is crucial to the decision of withdrawing antiepileptic drugs (AED). The prognostic value of the electroencephalogram (EEC) is still subject of controversy. The purpose of this study was to assess anticipatory information provided by EEC monitoring of epileptiform abnormalities before and during withdrawal of AED, and to evaluate the respective value of ambulatory (AEEG) and conventional EEC (CEEG). Materials and methods The requirements for admission to the study were a positive diagnosis of epilepsy and the absence of seizures for at least three years. Fifty-three subjects aged 9 to 64 years were selected from the outpatient population of the Epilepsy Centre of the Department of Neurological Sciences of "La Sapienza" University in Rome. Twenty-four had a diagnosis of generalized epilepsy (GE) and 29 of partial epilepsy (PE). The procedure consisted in withdrawal from therapy in 9 months by reducing the dose by one-fourth every 3 months, and in assessing CEEG, 24-hour AEEG and the plasma level of the AED at the following intervals: 0, 3 months, 6 months, 9 months and 12 months (only for the EEC). The CEEG and AEEG analysis, with quantification of abnormalities, was carried out blindly after the conclusion of the study. Results Forty-three patients concluded the study, 20 with GE and 23 with PE. Twenty-one patients (48.8%) showed a relapse, 9 with GE (45%) and 12 with PE (52%). Of the 9 patients with GE who suffered a relapse, 6 patients underwent the recurrence of seizures during the reduction of therapy and 3 patients after the conclusion of AED withdrawal. Of the 12 patients with PE who relapsed, 3 (25%) underwent relapses during the reduction and 9 (75%) after the conclusion of withdrawal. AEEG showed a better prognostic value than CEEG (/>=0.029) since 13 out of 21 (61.9% ) patients who relapsed showed worsening of AEEG in the course of withdrawal compared with 4 ( 19%) who showed worsening of CEEG. The results are particularly significant for PE (8 AEEG worsening out of 12, compared with 2 CEEG worsening: />=0.0018). Conclusion Better anticipatory information provided by AEEG with respect to CEEG depends on two reasons, the long duration of recording and the possibility of monitoring an entire sleep-waking cycle.

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