Association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigine
BackgroundInterictal epileptiform discharges (IEDs) are an electrographic biomarker of epilepsy. Despite their crucial role in diagnosing epilepsy, heterogeneous findings exist on the mechanisms underlying their occurrence and the effects of anti-seizure medications (ASMs) on IEDs.MethodsWe conducte...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1524637/full |
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| author | Johannes D. Lang Alexander Willno Caroline Reindl Tamara Welte Jenny Stritzelberger Stephanie Gollwitzer Katrin Walther Hajo Hamer |
| author_facet | Johannes D. Lang Alexander Willno Caroline Reindl Tamara Welte Jenny Stritzelberger Stephanie Gollwitzer Katrin Walther Hajo Hamer |
| author_sort | Johannes D. Lang |
| collection | DOAJ |
| description | BackgroundInterictal epileptiform discharges (IEDs) are an electrographic biomarker of epilepsy. Despite their crucial role in diagnosing epilepsy, heterogeneous findings exist on the mechanisms underlying their occurrence and the effects of anti-seizure medications (ASMs) on IEDs.MethodsWe conducted a study to investigate the association between IED frequency and the serum concentration of two commonly used ASMs, levetiracetam (LEV) and lamotrigine (LTG). We included 56 patients undergoing a continuous video EEG monitoring in our center with tapering of ASM. IED frequency was analyzed using automated and semiautomated methods and serum samples were collected sequentially throughout the stay.ResultsThe cohort consisted of 41 patients (23 female, 18 male), between 19 and 64 years (mean 37.42 years), most of which were diagnosed with focal epilepsy (93%). IED frequency increased after ASM reduction revealing a negative correlation similarly with LEV and LTG serum concentrations (p = 0.0057 and p = 0.0426, respectively).DiscussionNotably, we observed a significant increase in IED frequency following dose reduction or discontinuation of both medications. This effect was reversed after ASM were re-dosed. This may indicate the suppressive properties of LEV and LTG against epileptic seizures. Furthermore, our study highlights the importance of ASM discontinuation, which may be required for capturing IEDs during diagnostic continuous EEG monitoring, and not be fully explained by circadian or ultradian rhythms alone.ConclusionOur findings contribute to the understanding of ASM effects on IED frequency dynamics and suggest seizure suppressive properties of LEV and LTG. |
| format | Article |
| id | doaj-art-7ff3c434b3cc44e9a2e294a3268725c1 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-7ff3c434b3cc44e9a2e294a3268725c12025-01-24T05:21:22ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.15246371524637Association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigineJohannes D. LangAlexander WillnoCaroline ReindlTamara WelteJenny StritzelbergerStephanie GollwitzerKatrin WaltherHajo HamerBackgroundInterictal epileptiform discharges (IEDs) are an electrographic biomarker of epilepsy. Despite their crucial role in diagnosing epilepsy, heterogeneous findings exist on the mechanisms underlying their occurrence and the effects of anti-seizure medications (ASMs) on IEDs.MethodsWe conducted a study to investigate the association between IED frequency and the serum concentration of two commonly used ASMs, levetiracetam (LEV) and lamotrigine (LTG). We included 56 patients undergoing a continuous video EEG monitoring in our center with tapering of ASM. IED frequency was analyzed using automated and semiautomated methods and serum samples were collected sequentially throughout the stay.ResultsThe cohort consisted of 41 patients (23 female, 18 male), between 19 and 64 years (mean 37.42 years), most of which were diagnosed with focal epilepsy (93%). IED frequency increased after ASM reduction revealing a negative correlation similarly with LEV and LTG serum concentrations (p = 0.0057 and p = 0.0426, respectively).DiscussionNotably, we observed a significant increase in IED frequency following dose reduction or discontinuation of both medications. This effect was reversed after ASM were re-dosed. This may indicate the suppressive properties of LEV and LTG against epileptic seizures. Furthermore, our study highlights the importance of ASM discontinuation, which may be required for capturing IEDs during diagnostic continuous EEG monitoring, and not be fully explained by circadian or ultradian rhythms alone.ConclusionOur findings contribute to the understanding of ASM effects on IED frequency dynamics and suggest seizure suppressive properties of LEV and LTG.https://www.frontiersin.org/articles/10.3389/fneur.2024.1524637/fullspikesinterictal epileptiform dischargesanti-seizure medicationanticonvulsantsantiepileptic drugs |
| spellingShingle | Johannes D. Lang Alexander Willno Caroline Reindl Tamara Welte Jenny Stritzelberger Stephanie Gollwitzer Katrin Walther Hajo Hamer Association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigine Frontiers in Neurology spikes interictal epileptiform discharges anti-seizure medication anticonvulsants antiepileptic drugs |
| title | Association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigine |
| title_full | Association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigine |
| title_fullStr | Association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigine |
| title_full_unstemmed | Association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigine |
| title_short | Association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigine |
| title_sort | association of interictal epileptiform discharges and serum concentration of levetiracetam and lamotrigine |
| topic | spikes interictal epileptiform discharges anti-seizure medication anticonvulsants antiepileptic drugs |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1524637/full |
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