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.
authors: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, U.S.A.|Department of Child Neurology, Hospital Sant Joan de Déu, University of Barcelona, Spain.
authors: Iván
authors: I
authors: Sánchez Fernández
authors: Department of Child Neurology, Hospital Sant Joan de Déu, University of Barcelona, Spain.
authors: Tobias
authors: T
authors: Loddenkemper
authors: Saul R. Korey Department of Neurology, Dominick P. Purpura Department of Neuroscience, Laboratory of Developmental Medicine, Montefiore/Einstein Epilepsy Management Center, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A.
authors: Aristea S
authors: AS
authors: Galanopoulou
authors: Saul R. Korey Department of Neurology, Dominick P. Purpura Department of Neuroscience, Laboratory of Developmental Medicine, Montefiore/Einstein Epilepsy Management Center, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A.|Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A.
authors: Solomon L
authors: SL
authors: Moshé
mesh_terms: D000067877:Autism Spectrum Disorder / Q000503:physiopathology; D058256:Brain Waves / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology*; D004827:Epilepsy / Q000150:complications* / Q000628:therapy*; D007839:Functional Laterality; D006801:Humans; D008607:Intellectual Disability / Q000209:etiology; D007806:Language Disorders / Q000209:etiology; D009483:Neuropsychological Tests
keywords: Antiepileptic drugs; Cognition; Epileptiform discharges; Memory; Sleep