Intractability in Epilepsy: Role of EEG Desynchronization in Early Identification

• Published in: Clinical EEG and neuroscience 2015-07, Vol.46 (3), p.266-267
• Main Author: Jaseja, Harinder
• Format: Article
• Language: English
• Subjects: Convulsions & seizures; Early Diagnosis; Electroencephalography - methods; Electroencephalography Phase Synchronization; Epilepsy; Epilepsy - diagnosis; Epilepsy - physiopathology; Eye movements; Humans; Sleep; Sleep Wake Disorders - diagnosis; Sleep Wake Disorders - physiopathology; Sleep, REM
• ISSN: 1550-0594; 2169-5202
• DOI: 10.1177/1550059414528311

In view of several studies that have reported decreased REMS in IE, and its restoration and even enhancement by alternative therapies like ketogenic diet, vagal nerve stimulation, temporal lobe surgery, REMS has been proposed as a biomarker of IE.9 This has led to the suggestion of superiority of polysomnography over EEG, in assessment of epilepsy. 10 The protective antiepileptic action of REMS possibly follows a linear relation to the duration of REMS.11 Based on the strong antiepileptic action of REMS, a novel therapy has also been proposed for IE.12 Induction of desynchronization, usually at high frequencies in the range of 100 to 180 Hz, has been proposed as an important objective of deep brain stimulation (DBS).13 In the author's experience, in patients with IE who underwent bilateral anterior thalamic nucleus DBS, at routine high frequencies of stimulation, desynchronization was significantly more difficult to attain in patients who responded poorly.