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Interictal spikes on intracranial recording: behavior, physiology, and implications
Susan S Spencer1, Irina I Goncharova, Robert B Duckrow
1Department of Neurology, Yale University School of Medicine, New Haven, Connecticut 06520, USA. susan.spencer@yale.edu
Epilepsia
|May 16, 2008
Summary
Interictal spikes (IISs) decrease with antiepileptic drug (AED) withdrawal. Medial temporal lobe seizures increase IISs post-seizure, unlike neocortical seizures, aiding localization.
Area of Science:
- Neuroscience
- Clinical Neurology
- Epileptology
Background:
- The clinical significance of interictal spikes (IISs) in epilepsy is not fully understood.
- Investigating IISs' relationship with seizures and antiepileptic drugs (AEDs) can offer insights into epilepsy mechanisms.
Purpose of the Study:
- To systematically analyze the frequency, occurrence, and distribution of IISs in refractory epilepsy patients.
- To examine the impact of AEDs and seizure events on IIS rates.
Main Methods:
- Continuous IIS counts were recorded from intracranial electrodes in 34 epilepsy patients.
- Spike rates were analyzed across six defined 24-hour intervals relative to medication and seizure status.
Main Results:
- A significant decrease in IIS rate was observed following AED withdrawal (p < 0.0001).
- IIS rates significantly increased in the 24 hours post-seizure for medial temporal lobe seizures, but not for neocortical onset seizures.
Conclusions:
- AED withdrawal generally affects IIS rates, while medial temporal lobe seizures specifically increase post-seizure IISs.
- Quantifying IIS changes with AED modifications may reveal AED efficacy.
- IIS rate variability post-seizure can help distinguish seizure onset localization.
