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Incidental epileptiform discharges in patients of a tertiary centre
Stefan Seidel1, Eleonore Pablik2, Susanne Aull-Watschinger1
1Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Objective:
This controlled study set out to assess the rate of incidental epileptiform discharges (ED) during routine EEG and the incidence of epilepsy within a 4-year follow-up period in patients without a history of epilepsy.
Methods:
We retrospectively analyzed electroencephalography (EEG) recordings of 1750 consecutive patients referred to the Department of Neurology at the Vienna General Hospital between January 1 and December 31, 2009. The incidence of epilepsy in patients with ED and no prior history of epilepsy was compared with a disease control group matched for gender and neuroimaging findings.
Results:
ED were identified in 26 (4%) of 629 patients without a history of epilepsy. Sixteen (62%) of these patients developed epilepsy during follow-up compared with five (19%) of the disease controls (p=0.01), yielding an adjusted odds ratio of 8.8 (95% CI 2.1-37.7) for developing epilepsy in patients with ED and no prior history of epilepsy.
Conclusions:
Incidental ED during routine EEG significantly increase the likelihood of developing epilepsy.
Significance:
Patients with incidental ED should be specifically asked for any signs and symptoms suggestive of seizures, since they appear more prone to develop epilepsy.
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