The effect of antiepileptic drugs on epileptiform discharges in genetic generalized epilepsy: A systematic review

Abstract Objective The objective of this study was to evaluate the current evidence regarding the effect of antiepileptic drugs (AEDs) on epileptiform discharge (ED) burden in genetic generalized epilepsy (GGE). Methods We conducted a comprehensive literature search of PubMed, Embase, PsycINFO, and the Web of Science Core Collection databases using the keywords ‘genetic generalized epilepsy’, ‘antiepileptic drugs’ and ‘epileptiform discharge’. Primary human studies published in English that reported the effect of AEDs on EDs captured on electroencephalogram (EEG) recordings of at least 24 h in duration in patients with GGE were included. Results Six studies published between 1984 and 2017, which reported the effect of AEDs on EDs, involving a total of 116 patients with GGE, were analyzed. Our systematic review found a tendency for AEDs to reduce ED density, frequency, cumulative duration, and burst duration in GGE. Furthermore, we found evidence that the AED-mediated reduction in ED burden was associated with improved seizure control and cognitive outcomes. Conclusions Antiepileptic drugs tend to reduce ED burden in GGE, but the significance of this association remains uncertain.