The findings of this study suggest that the presence of RMT with tempo-parietal localization on the interictal EEG can anticipate reocurrence of seizures if Dep dose will be reduced or withdrawn. The efficacy of the AED therapy can be revealed via reduction of low-frequency waves and suppression of epileptiform EEG elements parallel to clinical improvement. Thus, optimal treatment strategies can be tailored based on the evaluation of background EEG characteristics using spectral analysis, EEG mapping, and the quantitative EEG approach.

Background: The analysis of the dynamics of background EEG characteristics on the different stages of CBZtherapy is very important for revealing the possible early predictors of benefit/adverse effects of the treatment and optimizing the anti-epileptic therapy. Objective: Evaluate the carbamazepine (CBZ) effect on the dynamics of EEG pattern in epileptic children at different stages of CBZ-monotherapy. Methods: Forty-five children (aged 3-9) with partial epilepsy were investigated. The EEG was recorded at rest and during functional tests prior to CBZ administration and three and six months after the initiation of CBZtherapy. Epileptiform graphoelements and baseline EEG activities were analyzed. Results: Following three months of CBZ-therapy an absolute power value in the low frequency bands of EEG spectrum increased while an average frequency of alpha waves decreased. During rest, CBZ reduced density of spontaneous epileptiform graphoelements and generalized epileptiform bursts. Generalized paroxysmal bursts decreased under functional tests. The EEG pattern maintained the same characteristics for six months. Deterioration of EEG pattern and clinical signs was observed in four children. Conclusion: Elevation of indices of low frequency bands, especially in occipital and parietal regions, concomitant with reduction of epileptiform elements and seizure frequency three months after initiation of therapy suggests that CBZ in appropriate doses might be continued. Otherwise, the strategy of antiepileptic therapy should be revised.

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In a group of 96 children and teenagers suffering from absence epilepsy, we compared the efficacy of treatment with a valproic acid derivative, Depakin (D). In 72 patients of group 1, EEGs contained bursts of typical absence seizure phenomena, generalized 3-4 Hz spike/wave complexes, SWCs. In 24 patients of group 2, these EEG phenomena were combined with other types of epileptiform elements (generalized and focal irregular peak/wave complexes, single and grouped sharp waves, spikes, polyspikes, etc.). It was found that pharmacotherapy with D effectively eliminated SWCs generated in the resting state of the patients; epileptiform phenomena provoked by hyperventilation and rhythmic photostimulation were noticeably more resistant from this aspect. The efficacy of treatment with D was considerably higher in group 1 (patients with the EEG patterns including only SWCs) than in group 2 (patients with deviating EEG patterns containing, together with SWCs, epileptiform elements of other types). Six months after the D therapy initiation, complete elimination of typical 3-4 Hz SWCs was observed in 63.9% of group-1 patients and in 41.7% of group-2 patients.

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