Neurosurgery Blog: Virtual Car Accident Rates Of Epilepsy Patients Are Significantly Increased By Interictal Generalized Spike Waves (S43.004)

Monday, April 21, 2014

Virtual Car Accident Rates Of Epilepsy Patients Are Significantly Increased By Interictal Generalized Spike Waves (S43.004)

Neurology recent issues

OBJECTIVE: To assess the type of interictal epileptic activity (IEA) with respect to its frequency, focal or generalized distribution and potential configuration that has relevant or negligible effects on reaction time (RT) slowing and errors in a driving simulator context.BACKGROUND: Creation of a tool for objective and reproducible judgment of the compatibility of an epilepsy patient`s EEG for driving, which is required by individual national driving guidelines.DESIGN/METHODS: The reaction time-EEG (RT-EEG) is an EEG registration while patients play a car driving game on a laptop. It records patients` RT to obstacles that are triggered during baseline EEG and IEA. Errors (crashes) correspond to RT prolongations 蠅 1 s. 40 RT-EEG of 34 epilepsy patients with generalized IEA and 14 RT-EEG of 12 patients with focal IEA were recorded.RESULTS: RT were prolonged during generalized IEA by 122 ms and during focal IEA by 31 ms, irrespective of potential configuration. Generalized IEA with predominant potential configuration of classical or atypical spike waves, or sharp theta activity prolonged RT by 278, 126, and 84 ms, respectively. Focal IEA with atypically configured spike waves or sharp theta activity prolonged RT by 48 and 15 ms, respectively. 1.2% of focal and 5% of generalized IEA caused errors. Among generalized IEA, 20% of bursts with classically configured spike waves, 0.8% of bursts with atypical spike waves, and 1.2% of bursts with sharp theta activity caused errors.CONCLUSIONS: Generalized IEA with classically configured spike waves strongly prolongs RT and causes many errors. Focal or generalized IEA with atypically configured spikes or sharp theta activity moderately prolong RT and cause low error rates.

Disclosure: Dr. Krestel has nothing to disclose. Dr. von Allmen has nothing to disclose. Dr. Liechti has nothing to disclose. Dr. Steinlin has nothing to disclose. Dr. Mathis has nothing to disclose. Dr. Arto has nothing to disclose.

Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/S43.004?rss=1