Anti-seizure Medication Load Is Not Correlated with Early Seizure Termination
Abstract number :
1.089
Submission category :
1. Basic Mechanisms / 1F. Other
Year :
2024
Submission ID :
208
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Nathan Evans, Mphys – Newcastle University
Sarah J Gascoigne, BSc, MSc – Newcastle University
Guillermo Besne, PhD – Newcastle University
Fahmida Chowdhury, PhD – University College London
Jane de Tisi, BSc – University College London
Beate Diehl, MD – University College London
John Duncan, MD – University College London
Christopher Thornton, PhD – Newcastle University
Yujiang Wang, PhD – Newcastle University
Rationale:
The mechanisms of seizure termination, and how different treatments affect them are not fully understood. Most seizures will terminate on their own, but the longer a seizure lasts the more severe they tend to be. A better understanding of when these more severe seizures will happen, or even causing early termination when they do occur, would be incredibly beneficial to the quality of life of people with epilepsy. Recent studies show that seizure progression from onset to termination follows a few select "pathways". These findings highlight the existence of seizures with a truncated progression reaching termination prematurely while other seizures continue though the complete pathway (Schroeder G et al. Brain Communications 2022 4(4)). In this study we compared truncated and continuing seizures, analysing the effects of anti-seizure medications (ASMs) on the prevalence of truncation.
Methods:
Retrospective analysis of intracranial electroencephalography (icEEG) recordings from 15 subjects who underwent medication tapering found 216 pairs of these truncated and continuing seizures. We compared the relative ASM load between truncated and continuing seizures within each pair to determine if a larger ASM load was causing the early termination of seizures.
Results:
ASM load preceding truncated seizures is not significantly higher than medication load before continuing seizures (paired t-test, t=0.1, p=0.9). On average, there was less than a 1% variation between the ASM load at the time of truncated seizures compared to continuing seizures.
Conclusions:
While higher medication load is correlated with shorter seizure durations, the lack of correlation with pathway truncation suggests that a separate mechanism is causing these early terminations. Truncated seizures recorded from pre-surgical icEEG implants may be incredibly useful for understanding the mechanisms governing early termination of seizures across a much wider cohort of people with epilepsy where such invasive monitoring isn't feasible.
Funding:
This work was funded by the Epilepsy Research Institute UK
Basic Mechanisms