@article{01HPP5JHA0Q2N2YD88281N40RM,
  abstract     = {{Objective: To determine the influence of antiseizure medication (ASM) withdrawal on interictal epilepto-genic discharges (IEDs) in scalp-EEG and seizure propensity.Methods: We included 35 adult unifocal epilepsy patients admitted for presurgical evaluation in the EEG and Epilepsy Unit of Geneva between 2016 and 2020, monitored for at least 5 days. ASM was individually tapered down, and automated IED detection was performed using Epilog PreOp (Epilog NV, Belgium, Ghent). We compared spike rate per hour (SR) at day 1 when patients were on full medication (baseline) with SR at the day with the lowest dose of medication. To determine possible peri-ictal changes of SR, we compared SR 8 h before and after a seizure with the SR at the same time of the baseline day.Results: Our results showed a significant increase in spiking activity in the day of lowest drug load if com-pared to spike rate at day on full medication (p < 0.001). The total amount of spikes during 24 h correlated significantly with seizure occurrence (p < 0.0001). We also revealed significant increase in peri-ictal SR, in particular 2-4 h preceding a seizure (p = 0.05) extending up to 3 h after the seizure (p = 0.03) with a short decrease just before seizure occurrence.Conclusions: Our results suggest that SR increases with medication withdrawal and particularly before and after seizures. There is a complex pattern of increase and decrease around seizure onset which explains divergent results in previous studies. Significance: Precise spike counting at similar circadian periods for a patient could help to determine the risk of seizure occurrence in a personalized fashion.(c) 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).}},
  author       = {{De Stefano, Pia and Menetre, Eric and  Vulliemoz, Serge and van Mierlo, Pieter and  Seeck, Margitta}},
  issn         = {{2467-981X}},
  journal      = {{CLINICAL NEUROPHYSIOLOGY PRACTICE}},
  keywords     = {{EEG,Spike,Interictal discharges,Seizure,Seizure risk,Withdrawal,Anti-epileptic drugs,Anti-seizure medication,Circadian profile,PROGNOSTIC-SIGNIFICANCE,LONG-TERM,SPIKES,EPILEPSY,RECURRENCE,FREQUENCY}},
  language     = {{eng}},
  pages        = {{279--284}},
  title        = {{Changes of interictal epileptiform discharges during medication withdrawal and seizures : a scalp EEG marker of epileptogenicity}},
  url          = {{http://doi.org/10.1016/j.cnp.2022.09.004}},
  volume       = {{7}},
  year         = {{2022}},
}

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