title: Association of Interictal Epileptiform Discharges with Sleep and Anti-Epileptic Drugs.
abstract: BACKGROUND
  The presence of interictal epileptiform discharges (IEDs) in electroencephalogram (EEG) is diagnostic of epilepsy. Latent IEDs are activated during sleep. Anti-epileptic drugs (AEDs) improve sleep. AEDs, sleep, and IEDs may interact and affect epilepsy management.
  
  
  OBJECTIVE
  To explore the occurrence of IEDs and its association with sleep and AED status in suspected patients of epilepsy.
  
  
  METHODS
  EEG records were collected of suspected patients of epilepsy who reported to the electrophysiology laboratory of a tertiary care hospital during 1 year. The anthropometric details, clinical presentations, and AED status of the patients were recorded from the EEG records. Patients were divided into 2 categories based on whether AEDs had been started prior to the EEG evaluation (category-I) or not (category-II). The occurrences of IEDs in EEG recordings in both categories were analyzed.
  
  
  RESULTS
  In 1 year, 138 patients were referred for diagnostic EEG evaluation. One-hundred-two patients fulfilled the inclusion criteria, of which 57 patients (53%) belonged to category-I and 45 patients (47%) belonged to category-II. Incidence of IEDs, suggestive of definite diagnosis of epilepsy in category-I was 88% and in category-II was 69%, and this difference was statistically significant (p = 0.02).
  
  
  CONCLUSIONS
  The increased proportion of IEDs in category-I patients may be due to high clinical suspicion or compounding interaction of AEDs and sleep. More extensive studies are required to delineate the complex interaction of AEDs, sleep, and IEDs so that judicious yet prompt management of epilepsy can be carried out.
authors: Department of Physiology, All India Institute of Medical Sciences, Rishikesh, India.
authors: Latika
authors: L
authors: Mohan
authors: Department of Physiology, All India Institute of Medical Sciences, Rishikesh, India.
authors: Jayvardhan
authors: J
authors: Singh
authors: Department of Physiology, All India Institute of Medical Sciences, Rishikesh, India.
authors: Yogesh
authors: Y
authors: Singh
authors: Department of Physiology, All India Institute of Medical Sciences, Rishikesh, India.
authors: Rajesh
authors: R
authors: Kathrotia
authors: Department of Physiology, All India Institute of Medical Sciences, Rishikesh, India.
authors: Arun
authors: A
authors: Goel
keywords: Anti-epileptic drugs; Electroencephalogram; Interictal epileptiform discharges; Seizures