Treating nonepileptics with anticonvulsants based on EEG findings

What is it about?

Although antiepileptic drugs (AEDs) are prescribed to nonepileptic patients with a variety of diagnoses, the FDA has only approved their use for a small number of psychiatric conditions. Previous research recommends an empirical trial of AEDs when isolated epileptiform discharges (IEDs) are identified in the electroencephalogram (EEG). The purpose of this study was to evaluate the outcome of treating nonepileptic patients with AEDs when IEDs are present. The sample was comprised of 76 refractory cases from a multidisciplinary practice whose EEG readings contained IEDs. The psychiatrist’s progress notes were assessed to determine the impact of adding anticonvulsants based on parent, teacher reports and clinical observation. The findings found that the majority of the patients improved (85.53%) when AEDs were prescribed. These results suggest that IEDs may predict positive treatment outcome to anticonvulsant medication regardless of age, gender, or diagnosis.

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Why is it important?

This is the first study to be published on the use of anticonvulsants on nonepileptic patients based solely on the identification of epileptiform activity in their EEGs. Regardless of age, gender, or diagnosis 85.5% of these 76 patients improved. This is important because they had all failed multiple medication attempts.