Epilepsy instructor University of Pennsylvania Philadelphia, Pennsylvania
Rationale: To test the hypothesis that the recently-described1, 2 EEG feature generalized polyspike train is associated with drug-resistant idiopathic generalized epilepsy. Methods: We conducted a single-center retrospective analysis of patients with idiopathic generalized epilepsy who had outpatient EEGs performed between 2016 and 2020. We classified patients as drug resistant or drug responsive based on clinical review. We reviewed EEG data for the presence and timing of generalized polyspike train (a burst of generalized rhythmic spikes lasting less than one second). We tested for a relationship between generalized polyspike train and drug resistance before and after controlling for EEG duration. We also calculated the EEG duration required to observe generalized polyspike train. Results: We included 102 patients (69% drug responsive and 31% drug resistant). Generalized polyspike train was non-significantly more prevalent in drug resistant IGE (OR = 3.0, 95% CI 1.0-9.2, p = 0.07). This finding persisted when controlling for EEG duration both with stratification and survival analysis. A median of 5.1 hours (interquartile range 0.4-13.3 hours) of EEG recording was required to capture the first occurrence of generalized polyspike train. Conclusions: The presence of generalized polyspike train may predict drug resistant idiopathic generalized epilepsy. Prolonged EEG recording is likely required to identify this feature.
1. Sun Y, Seneviratne U, Perucca P, et al. Generalized polyspike train: An EEG biomarker of drug-resistant idiopathic generalized epilepsy. Neurology. 2018;91:e1822–e1830.
2. Jensen CD, Gesche J, Krøigård T, Beier CP. Prognostic value of generalized polyspike trains and prolonged epileptiform EEG runs. J Clin Neurophysiol [online serial]. Epub 2019. Accessed at: https://dx.doi.org/10.1097/WNP.0000000000000679. Funding: Please list any funding that was received in support of this abstract.: NA