Association between Interictal Spike Rate and Seizure Frequency in a Large Epilepsy Cohort
Medrxiv : the Preprint Server for Health Sciences
|June 29, 2026
Summary
Interictal spike rate on routine EEG is linked to seizure frequency in epilepsy patients. This association is strongest in generalized epilepsy, suggesting spike rate can quantify seizure burden.
Area of Science:
- Neurology
- Clinical Neurophysiology
- Epilepsy Research
Background:
- Seizure frequency tracking is vital for epilepsy prognostication and treatment.
- Interictal spikes are potential biomarkers for seizure burden, but their quantification across epilepsy subtypes is limited.
Purpose of the Study:
- To quantify the association between interictal spike rate and seizure frequency.
- To investigate how this association varies across different epilepsy subtypes.
Main Methods:
- Utilized 3,614 routine EEGs from 3,245 epilepsy patients.
- Employed automated detection (SpikeNet2) for spike frequency and NLP for seizure frequency extraction.
- Analyzed correlations between spike rate (spikes/hour) and seizure frequency (seizures/month) across epilepsy subtypes.
Main Results:
- A modest overall association between spike rate and seizure frequency (ρ = 0.11).
- Significant positive associations found in generalized epilepsy (ρ = 0.23) and temporal lobe epilepsy (ρ = 0.12).
- No significant association observed in frontal lobe epilepsy (ρ = 0.11).
Conclusions:
- Higher interictal spike rates correlate with higher seizure frequencies in epilepsy.
- Interictal spike rate serves as a quantitative EEG marker for seizure burden.
- Spike rate may aid in risk stratification and monitoring treatment response in epilepsy management.
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