IEC 2021 | Investigating the association of interictal spiking pattern changes with seizures
Anca Arbune, MD, PhD, Fundeni Clinical Institute, Bucharest, Romania, discusses the intriguing question of whether specific interictal spikes indicate a positive or adverse outcome for patients prone to seizures. For example, certain spiking grades can mean smaller discharges that prevent the occurrence of seizures. Other spikes have been recorded to have occurred more frequently at longer time spans before a seizure occurs, like a buildup. It is still unclear why some patients with the same diagnosis, such as focal temporal epilepsy, have different effects on these spikes. Another point of interest is also that the same patient may exhibit multiple types of spikes. It is really important to be able to distinguish between different types of spikes and more research is needed to classify them. This is because this may indicate whether a patient will have a seizure in the next couple of hours. This interview took place during the 34th International Epilepsy Congress, 2021.
Transcript (edited for clarity)
The intriguing question was whether specific spikes are good or bad for seizures. It has been documented that specific types of spikes and a certain spiking rate can actually mean smaller discharges that prevent the occurrence of the seizure. While other types of spikes have been recorded as coming more frequently and in longer time spans before a seizure actually occurs, like a buildup. And it was not clear why patients with the same diagnosis, for example, focal temporal epilepsy have different effects of these spikes...
The intriguing question was whether specific spikes are good or bad for seizures. It has been documented that specific types of spikes and a certain spiking rate can actually mean smaller discharges that prevent the occurrence of the seizure. While other types of spikes have been recorded as coming more frequently and in longer time spans before a seizure actually occurs, like a buildup. And it was not clear why patients with the same diagnosis, for example, focal temporal epilepsy have different effects of these spikes. And actually, it was really interesting to find that in a specific patient, there are multiple types of spikes, even when analyzing their distribution and their focus. We used the BESA software to do this analysis. And in the same patient, we actually found both types, some that occurred specifically before a seizure and others that occurred before a longer time span of the seizure.
So a specific spike could have a buildup in the first two hours before a seizure. And the specific spike would be actually the aftermath of another seizure. And this is actually really important to know, and we should distinguish between these types of spike. And I hope that more research in this domain will actually lead us to a better understanding and maybe classify in the patient whether those types of spikes are suggestive of a seizure coming up in this next days or hours, or it actually means that the patient is in a steady-state and no seizure will occur in the next time-span. This would actually have a great impact on planning your day and planning your activities as a patient. So, yes, this is just the beginning.
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