Gabapentin-Induced Modulation of Interictal Epileptiform Activity Related to Different Vigilance Levels
Abstract number :
3.147
Submission category :
Year :
2000
Submission ID :
1098
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Francesca Spanedda, Fabio Placidi, Andrea Romigi, Donatella Mattia, Mario Tombini, Francesca Izzi, Francesca Sperli, Maria Grazia Marciani, Fondazione I R C C S Santa Lucia, Roma, Italy; Universita' degli Study di Rome Tor Vergata, Roma, Italy; Acad degli
RATIONALE:_Gabapentin (GBP) has a clinical efficacy in focal epilepsy under conventional antiepileptic drugs (AEDs).We evaluated the effects of GBP therapy on the EEG epileptiform patterns in relation to the different levels of vigilance and on both EEG background activity and nocturnal sleep. METHODS: Twenty-five patients with cryptogenic or symptomatic partial epilepsy resistant to conventional AEDs were included in the study. All patients underwent long-term video-EEG recordings before and after GBP addition. Eighteen patients were also submitted to nocturnal polygraphic recordings under baseline condition and after drug addition. RESULTS: Quantitative analysis of the interictal EEG paroxysms revealed that GBP had no effect on the rate of occurrence of interictal epileptiform activity (IEA) recorded during wakefulness. GBP was active in delimiting the spatial extent of the interictal spiking activity in those patients who displayed a significant reduction (? 50%) in seizure occurrence (32% of the patients). We observed a significant increase in unilateral/focal IEA during the light NREM sleep and a significant reduction in bilateral/diffuse IEA during the wakefulness after sleep onset with respect to the baseline condition. A significant increase in REM sleep and slow wave sleep, associated with a reduction in the number of awakenings and Stage 1, were also observed after GBP therapy. Finally, EEG background activity recorded under rest condition from 18 out of the 25 epileptic patients, before GBP therapy, was characterised by a higher content of the slow spectral components (delta and theta) with respect to control subjects. After GBP addition, the increase of theta relative power was also evident during task performance._ CONCLUSIONS: These findings suggest that GBP therapy modulates the expression of IEA with different effects in relation to the various vigilance levels without interfering with the generation of EEG paroxysms. The utilisation of GBP in controlling focal seizures is reinforced by the absence of negative influence on cognitive functioning and by the improvement of the sleep pattern in epileptic patients.