AUTHOR=Fatima Safoora , Sun Mengzhen , Gjini Klevest , Struck Aaron F. TITLE=Association Between Lateralized Periodic Discharge Amplitude and Seizure on Continuous EEG Monitoring in Patients With Structural Brain Abnormality in Critical Illness JOURNAL=Frontiers in Neurology VOLUME=13 YEAR=2022 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.840247 DOI=10.3389/fneur.2022.840247 ISSN=1664-2295 ABSTRACT=Objective

To investigate the association between lateralized periodic discharge (LPD) amplitude and seizure risk on an individual level in patients with structural brain abnormality.

Methods

Retrospective case–control study of patients with structural brain abnormality undergoing continuous EEG monitoring was performed. We included 10 patients with LPDs and seizures as cases and 10 controls, patients with LPDs without seizure. Analysis was performed with a mixed-effects model with primary outcome measure of number of seizures per 8-h EEG epoch with fixed effects being variables of interest and random effect being subject ID.

Results

Epochs with seizures showed a higher absolute amplitude (corrected p = 0.04) and a higher relative amplitude (corrected p = 0.04) of LPDs. Additionally, the number of seizures was higher in epochs that had LPDs with plus features (uncorrected p = 0.002) and LPDs with higher relative amplitude (uncorrected p = 0.005).

Conclusion

Higher LPD amplitude is associated with increased risk of seizures on an individual patient level. A decreasing amplitude is suggestive of decreasing seizure risk, and may in fact be suggestive of decreasing ictal character of LPDs.