Edward Faught1, Ioannis Karakis2, Daniel L Drane2,3. 1. Emory University, Brain Health Center 292, 12 Executive Park Drive NE, Atlanta, GA, 30306, USA. rfaught@emory.edu. 2. Emory University, Brain Health Center 292, 12 Executive Park Drive NE, Atlanta, GA, 30306, USA. 3. University of Washington, Seattle, WA, USA.
Abstract
PURPOSE OF REVIEW: Our purpose is to review evidence relating to the concept that interictal epileptiform discharges (IEDs) impair brain performance. RECENT FINDINGS: Sophisticated measures of motor and cognitive performance have clarified older observations, confirming that in both animals and humans, IEDs affect aspects of performance, IED morphology, frequency, anatomical distribution, and duration matter. However, we now know that it is difficult to draw a line between IEDs and seizures, not only by electrical criteria but even by metabolic and molecular measures. IEDs impair performance acutely and probably chronically. Thus, there are good theoretical reasons for suppressing them, but no consensus has been reached on how much effort this deserves. Many antiepileptic medications effective for control of clinical seizures have little effect on IEDs. Better methods of measuring outcomes may allow selection of individual patients for whom treatment aimed at IEDs is worthwhile.
PURPOSE OF REVIEW: Our purpose is to review evidence relating to the concept that interictal epileptiform discharges (IEDs) impair brain performance. RECENT FINDINGS: Sophisticated measures of motor and cognitive performance have clarified older observations, confirming that in both animals and humans, IEDs affect aspects of performance, IED morphology, frequency, anatomical distribution, and duration matter. However, we now know that it is difficult to draw a line between IEDs and seizures, not only by electrical criteria but even by metabolic and molecular measures. IEDs impair performance acutely and probably chronically. Thus, there are good theoretical reasons for suppressing them, but no consensus has been reached on how much effort this deserves. Many antiepileptic medications effective for control of clinical seizures have little effect on IEDs. Better methods of measuring outcomes may allow selection of individual patients for whom treatment aimed at IEDs is worthwhile.
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