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Gabapentin as add-on therapy in focal epilepsy: a computerized EEG study
D Mattia1, F Spanedda, M A Bassetti
1IRCCS Santa Lucia, Rome, Italy. marciani@med.uniroma2.it
Summary
Gabapentin (GBP) effectively treats focal epilepsy by reducing seizure susceptibility and limiting the spatial spread of EEG abnormalities without affecting spike generation. This epilepsy treatment shows no negative impact on cognitive function.
Area of Science:
- Neuroscience
- Clinical Neurology
- Epileptology
Background:
- Gabapentin (GBP) is a known effective treatment for focal epilepsy resistant to other antiepileptic drugs (AEDs).
- Investigating GBP's impact on EEG activity is crucial for understanding its mechanism of action.
Purpose of the Study:
- To evaluate the effects of Gabapentin on EEG epileptiform activity and background rhythms in epilepsy patients.
- To assess if GBP influences the generation or spatial extent of interictal and ictal EEG abnormalities.
Main Methods:
- Twenty-five patients with refractory partial epilepsy underwent video-EEG monitoring before and after adding GBP (900-1200 mg/day).
- Quantitative EEG analysis focused on interictal paroxysms and background activity.
Main Results:
- Gabapentin did not alter the frequency of interictal or ictal EEG abnormalities.
- GBP reduced seizure occurrence by >=50% in 32% of patients, correlating with a limited spatial extent of interictal spiking.
- EEG background activity showed increased slow spectral components (delta, theta) after GBP, particularly theta during tasks.
Conclusions:
- Gabapentin does not interfere with interictal EEG spike generation but may reduce seizure susceptibility by limiting the spatial spread of activity.
- The findings support GBP's use in focal epilepsy, highlighting its lack of negative impact on cognitive function.