Should epileptiform discharges be treated?

Iván Sánchez Fernández, Tobias Loddenkemper, Aristea S. Galanopoulou, Solomon L. Moshe

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

To evaluate the impact of epileptiform discharges (EDs) that do not occur within seizure patterns - such as spikes, sharp waves or spike waves - on cognitive function and to discuss the circumstances under which treatment of EDs might be considered. Methods used in this article is "Review of the literature". EDs may disrupt short-term cognition in humans. Frequent EDs for a prolonged period can potentially impair long-term cognitive function in humans. However, there is conflicting evidence on the impact of EDs on long-term cognitive outcome because this relationship may be confounded by multiple factors such as underlying etiology, seizures, and medication effects. Limitations of existing studies include the lack of standardized ED quantification methods and of widely accepted automated spike quantification methods. Although there is no solid evidence for or against treatment of EDs, a non-evidence-based practical approach is suggested. EDs in otherwise asymptomatic individuals should not be treated because the risks of treatment probably outweigh its dubious benefits. A treatment trial for EDs may be considered when there is cognitive dysfunction or regression or neurologic symptoms that are unexplained by the underlying etiology, comorbid conditions, or seizure severity. In patients with cognitive or neurologic dysfunction with epilepsy or EDs, treatment may be warranted to control the underlying epileptic syndrome. EDs may cause cognitive or neurologic dysfunction in humans in the short term. There is conflicting evidence on the impact of EDs on long-term cognitive outcome. There is no evidence for or against treatment of asymptomatic ED.

Original languageEnglish (US)
Pages (from-to)1492-1504
Number of pages13
JournalEpilepsia
Volume56
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Neurologic Manifestations
Cognition
Seizures
Therapeutics
Epilepsy
Cognitive Dysfunction

Keywords

  • Antiepileptic drugs
  • Cognition
  • Epileptiform discharges
  • Memory
  • Sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Should epileptiform discharges be treated? / Sánchez Fernández, Iván; Loddenkemper, Tobias; Galanopoulou, Aristea S.; Moshe, Solomon L.

In: Epilepsia, Vol. 56, No. 10, 01.10.2015, p. 1492-1504.

Research output: Contribution to journalArticle

Sánchez Fernández, I, Loddenkemper, T, Galanopoulou, AS & Moshe, SL 2015, 'Should epileptiform discharges be treated?', Epilepsia, vol. 56, no. 10, pp. 1492-1504. https://doi.org/10.1111/epi.13108
Sánchez Fernández, Iván ; Loddenkemper, Tobias ; Galanopoulou, Aristea S. ; Moshe, Solomon L. / Should epileptiform discharges be treated?. In: Epilepsia. 2015 ; Vol. 56, No. 10. pp. 1492-1504.
@article{b1a54098ef9044b98ba3da39b539ea1b,
title = "Should epileptiform discharges be treated?",
abstract = "To evaluate the impact of epileptiform discharges (EDs) that do not occur within seizure patterns - such as spikes, sharp waves or spike waves - on cognitive function and to discuss the circumstances under which treatment of EDs might be considered. Methods used in this article is {"}Review of the literature{"}. EDs may disrupt short-term cognition in humans. Frequent EDs for a prolonged period can potentially impair long-term cognitive function in humans. However, there is conflicting evidence on the impact of EDs on long-term cognitive outcome because this relationship may be confounded by multiple factors such as underlying etiology, seizures, and medication effects. Limitations of existing studies include the lack of standardized ED quantification methods and of widely accepted automated spike quantification methods. Although there is no solid evidence for or against treatment of EDs, a non-evidence-based practical approach is suggested. EDs in otherwise asymptomatic individuals should not be treated because the risks of treatment probably outweigh its dubious benefits. A treatment trial for EDs may be considered when there is cognitive dysfunction or regression or neurologic symptoms that are unexplained by the underlying etiology, comorbid conditions, or seizure severity. In patients with cognitive or neurologic dysfunction with epilepsy or EDs, treatment may be warranted to control the underlying epileptic syndrome. EDs may cause cognitive or neurologic dysfunction in humans in the short term. There is conflicting evidence on the impact of EDs on long-term cognitive outcome. There is no evidence for or against treatment of asymptomatic ED.",
keywords = "Antiepileptic drugs, Cognition, Epileptiform discharges, Memory, Sleep",
author = "{S{\'a}nchez Fern{\'a}ndez}, Iv{\'a}n and Tobias Loddenkemper and Galanopoulou, {Aristea S.} and Moshe, {Solomon L.}",
year = "2015",
month = "10",
day = "1",
doi = "10.1111/epi.13108",
language = "English (US)",
volume = "56",
pages = "1492--1504",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Should epileptiform discharges be treated?

AU - Sánchez Fernández, Iván

AU - Loddenkemper, Tobias

AU - Galanopoulou, Aristea S.

AU - Moshe, Solomon L.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - To evaluate the impact of epileptiform discharges (EDs) that do not occur within seizure patterns - such as spikes, sharp waves or spike waves - on cognitive function and to discuss the circumstances under which treatment of EDs might be considered. Methods used in this article is "Review of the literature". EDs may disrupt short-term cognition in humans. Frequent EDs for a prolonged period can potentially impair long-term cognitive function in humans. However, there is conflicting evidence on the impact of EDs on long-term cognitive outcome because this relationship may be confounded by multiple factors such as underlying etiology, seizures, and medication effects. Limitations of existing studies include the lack of standardized ED quantification methods and of widely accepted automated spike quantification methods. Although there is no solid evidence for or against treatment of EDs, a non-evidence-based practical approach is suggested. EDs in otherwise asymptomatic individuals should not be treated because the risks of treatment probably outweigh its dubious benefits. A treatment trial for EDs may be considered when there is cognitive dysfunction or regression or neurologic symptoms that are unexplained by the underlying etiology, comorbid conditions, or seizure severity. In patients with cognitive or neurologic dysfunction with epilepsy or EDs, treatment may be warranted to control the underlying epileptic syndrome. EDs may cause cognitive or neurologic dysfunction in humans in the short term. There is conflicting evidence on the impact of EDs on long-term cognitive outcome. There is no evidence for or against treatment of asymptomatic ED.

AB - To evaluate the impact of epileptiform discharges (EDs) that do not occur within seizure patterns - such as spikes, sharp waves or spike waves - on cognitive function and to discuss the circumstances under which treatment of EDs might be considered. Methods used in this article is "Review of the literature". EDs may disrupt short-term cognition in humans. Frequent EDs for a prolonged period can potentially impair long-term cognitive function in humans. However, there is conflicting evidence on the impact of EDs on long-term cognitive outcome because this relationship may be confounded by multiple factors such as underlying etiology, seizures, and medication effects. Limitations of existing studies include the lack of standardized ED quantification methods and of widely accepted automated spike quantification methods. Although there is no solid evidence for or against treatment of EDs, a non-evidence-based practical approach is suggested. EDs in otherwise asymptomatic individuals should not be treated because the risks of treatment probably outweigh its dubious benefits. A treatment trial for EDs may be considered when there is cognitive dysfunction or regression or neurologic symptoms that are unexplained by the underlying etiology, comorbid conditions, or seizure severity. In patients with cognitive or neurologic dysfunction with epilepsy or EDs, treatment may be warranted to control the underlying epileptic syndrome. EDs may cause cognitive or neurologic dysfunction in humans in the short term. There is conflicting evidence on the impact of EDs on long-term cognitive outcome. There is no evidence for or against treatment of asymptomatic ED.

KW - Antiepileptic drugs

KW - Cognition

KW - Epileptiform discharges

KW - Memory

KW - Sleep

UR - http://www.scopus.com/inward/record.url?scp=84943200293&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84943200293&partnerID=8YFLogxK

U2 - 10.1111/epi.13108

DO - 10.1111/epi.13108

M3 - Article

VL - 56

SP - 1492

EP - 1504

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 10

ER -