Abstract:Many antiepileptic drugs (AEDs) have been tested on nonepileptic patients witha variety of diagnoses. The Food and Drug Administration has only approvedcertain AEDs for a small number of psychiatric conditions. There are fewstudies of nonepileptic patients that recommend an empirical trial of AEDs whenisolated epileptiform discharges (IEDs) are identified in theelectroencephalogram (EEG). However, no trials have been published. The purposeof this study is to evaluate the outcome of treating nonepileptic patients withAEDs when IEDs are present. Refractory cases were reviewed from amultidisciplinary practice whose EEG readings contained IEDs and weresubsequently medicated with anticonvulsants by the clinic’s psychiatrist. Thepsychiatrist’s progress notes were assessed to determine the impact of addinganticonvulsants based on parent reports, teacher reports, and clinicalobservation. The final sample was composed of 76 refractory cases. Of the 76patients treated with anticonvulsants, the majority were found to be improvedin follow-up progress notes: 65 improved (85.53%), 6 unchanged (7.89%), and 5more severe (6.58%). These observational findings suggest that further studieswill be needed to show that IEDs may predict positive treatment outcome toanticonvulsant medication and act as a step toward an evidence-based treatment.Also, EEG screening may prove to be useful for refractory cases regardless ofage, gender, or diagnosis.
