Zubeda Sheikh

A <20% ASBE burden has a 99% negative predictive value for ESE and 98% for ESE/pESE; this can be used to exclude ESE and pESE patterns. A >50% ASBE burden is 94% specific for ESE and 98% specific for ESE/pESE; this can be used for confirming a suspicion of ESE (in an appropriate clinical setting). The sensitivity even at >10% detection burden is only modest for electrographic seizure detection at 67% and low for seizures and highly epileptiform patterns at 44%.

Pearls “Subclinical” generalized epileptiform discharges in patients with generalized epilepsy may be associated with transitory cognitive impairment upon appropriate testing.1,-,4 Increased reaction time is the most sensitive behavioral correlate to these discharges.3,4 Duration of generalized spike-wave discharges is a likely determinant of increased reaction time and cognitive impairment.

Pearls and Oy-sters: Driving Safety in Photosensitive Genetic Generalized Epilepsy Mohamed Nasser, Zubeda Sheikh Neurology May 2021, 10.1212/WNL.0000000000012157; DOI: 10.1212/WNL.0000000000012157