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A decrease in EEG energy accompanies anti-epileptic drug taper during intracranial monitoring
Hitten P Zaveri1, Steven M Pincus, Irina I Goncharova
1Department of Neurology, Yale University, 333 Cedar Street, New Haven, CT 06520, USA. hitten.zaveri@yale.edu
Epilepsy Research
|July 28, 2009
Summary
Anti-epileptic drug tapering during intracranial EEG monitoring unexpectedly decreased signal energy, suggesting seizures may not solely stem from increased cortical excitation. This finding challenges current understanding of how these drugs prevent seizures.
Area of Science:
- Neuroscience
- Clinical Neurology
- Biomedical Engineering
Background:
- Tapering anti-epileptic drugs (AEDs) during intracranial EEG (icEEG) monitoring is known to increase seizure likelihood.
- This increase is presumed to result from heightened cortical excitation, promoting seizure emergence.
Purpose of the Study:
- To quantify changes in cortical excitation during AED taper by measuring signal energy in icEEG.
- To investigate the relationship between AED taper, signal energy, and seizure propensity.
Main Methods:
- Analyzed icEEG data from 12 adult patients undergoing AED taper.
- Selected 1-hour epochs before and after taper, excluding seizure periods.
- Estimated Teager energy (a measure of signal energy) in seizure onset regions and other monitored brain areas.
Main Results:
- Observed significant changes in Teager energy during icEEG monitoring.
- A dominant trend of decreased signal energy was noted post-AED taper.
- Signal energy decreased by 35% in both the seizure onset region and all monitored brain areas.
Conclusions:
- A decrease in signal energy accompanies AED taper during icEEG monitoring.
- This suggests AEDs may prevent seizures through mechanisms other than solely reducing cortical excitation.
- Seizure generation might be influenced by factors beyond poorly regulated cortical excitation.
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