The clinical value of long - term electroencephalogram (EEG) in seizure - free populations: implications from a cross-sectional study

Abstract

Backgroud: This study aimed to explore the clinical value of long-term electroencephalogram (LTM EEG) in seizure-free individuals taking antiepileptic drugs (AEDs) for more than 2 years. We try to look for clinical factors associated with epileptiform activity on LTM EEG in seizure free patients. We hope that the detection of epileptiform activity by the LTM EEG recording can develop the better treatment strategy. Methods: The LTM EEG recordings of 770 individuals with a definite diagnosis of epilepsy were assessed. Two hundred sixty-two individuals accorded with the inclusion criteria and exclusion criteria. We collect the demographic and clinical information and LTM EEG data of these 262 individuals. We analysed the data by one-way analysis of variance and Cox proportional hazards models. Results: We found that more epileptiform activity were found with LTM EEG recording than regular EEG recording in seizure-free individuals. We found several clinical factors could be associated with epileptiform activity on LTM EEG in seizure free patients by a one-way analysis: symptomatic or cryptogenic epilepsy [hazard ratio (HR) = 2.6], history of cerebral trauma (HR = 7.5), and abnormal imaging findings (HR = 3.1). The following factors suggested a correlation between history of cerebral trauma (HR = 2.4) and history of cerebral surgery (HR = 3.4) with epileptiform activity on LTM EEG presentation by multivariate logistic regression analysis. Conclusions: The study indicated a correlation of a number of factors with abnormal LTM EEG presentation: symptomatic or cryptogenic epilepsy, history of cerebral trauma, history of cerebral surgery, and abnormal imaging findings. The LTM EEG recording may help find epileptiform activity in high risk seizure-free individuals. The individuals need be reevaluated the therapeutic strateagies, and increase the hope to reach real seizure-free.

Electroencephalography at the height of a pandemic: EEG findings in patients with COVID-19

“…chronic stroke or encephalomalacia, acute ischemic or hemorrhagic infarcts, brain mass, anoxic brain injury, PRES but excluding incidental findings such as pineal gland cyst) and the presence of antiseizure medications or sedating infusions. These factors were included in the model as they have previously been shown to be associated with an abnormal EEG in prior studies ( Xinghua et al, 2020 ). Additionally, logistic regression analyses for the outcome of mortality at discharge were also performed.…”

Multichannel Synthetic Preictal EEG Signals to Enhance the Prediction of Epileptic Seizures

“…Most state-of-the-art seizure prediction machine learning algorithms extracted <30s segments from raw recordings as training samples, however, numerous recent studies raised that long-term EEG recordings in several minutes take an important role in overcoming limitations of epilepsy studies [47], [48]. Thus, we tested our proposed method to synthesize single-channel EEG recordings in 5 minutes.…”

A comparative study of EEG findings among subjects in seizure-remission and patients with epilepsy in a resource constrained west African psychiatric hospital.

“…findings have shown that aside from the clinical history of seizure remission in patients on AEDs, the predictive value of EEG had been shown to be far better than the clinical monitoring, that is EEG is much useful for longterm monitoring of seizure remission (11,12,13). Furthermore, previous studies have also shown that abnormal EEG, in this case, epileptiform activity is indicative of cortical hyperexcitability; and in subjects with a history of seizures such as our subjects in seizure-remission, the presence of epileptiform activity in them is useful in prognostication and prediction of possible seizure recurrence during AEDs withdrawal and/or period of seizure remission (25,26,27)…”

“…Among these factors, only EEG epileptiform activities can be monitored preferably using long term EEG recording (LTM EEG) which includes ambulatory EEG (aEEG) and video EEG (vEEG). These LTM EEG modalities are more sensitive to detect epileptiform activities, they have higher sensitivity and lower false negative rates to detect such abnormalities when compared with regular routine EEG recording (13). However, in a resource constrained setting such as Nigeria, LTM EEG techniques of aEEG and vEEG are not available, but only routine EEG recordings.…”