P EEG X TSC

• There are some indications suggesting that early treatment for epilepsy can help patients with tuberous sclerosis complex (TSC) and reduce the severity of the disease. These authors examined the EEGs of 32 infants who met the genetic or clinical criteria for TSC but who had not experienced any seizures yet, with the hope to identify EEG features that would predict development of epilepsy later on. Following these patients until the age of 2 years, the authors noted that the presence of interictal epileptiform discharges had a 77.3% positive predictive value and the absence a 70% negative predictive value for developing seizures by 2 years of age. They concluded that 1-hour awake and asleep EEG findings could serve as an early biomarker for developing epilepsy.

• This is an important study, deriving value from a commonly available test. As the use of genetic testing becomes more popular, and diagnosis of TSC can precede the appearance of every clinical feature, such biomarkers can serve an important function in predicting disease severity and identifying those who need more aggressive interventions.

– Omar Iqbal Khan, MD