Changes in epileptic spike configuration associated with attainment of seizure control

This study provides preliminary evidence that computer‐derived parameters of interictal spike waveforms can be used to assess seizures hazard in a quantitative manner. Thirteen children with spike foci and simple or complex partial seizures were studied before and during treatment with carbamazepine or phenobarbital; spike parameters were determined from 5‐ to 30‐minute electroencephalographic samples obtained during non–rapid eye movement sleep. Measurements included spike amplitude, duration, and sharpness, and a mathematical combination of these three parameters (the composite spike parameter). Achievement of seizure control was associated with a decrease in spike amplitude, duration, and composite spike parameter, and an increase in normalized sharpness, compared to baseline values. These result suggest that this method may provide a prospective means for estimating drug efficacy that can be applied shortly after attainment of steady‐state serum drug levels.