Assessment of drowsiness in epilepsy patients receiving chronic antiepileptic drug therapy

M. C. Salinsky, B. S. Oken, L. M. Binder

Research output: Contribution to journalArticle

68 Scopus citations

Abstract

Drowsiness is a common complaint among patients with epilepsy taking antiepileptic drugs (AEDs) and may be of particular importance because of the potential effects on cognitive abilities. We used a novel EEG-based measure (the Awake Maintenance Task, AMT) to determine objectively whether patients on chronic, stable AED therapy had impaired ability to maintain wakefulness. Thirty patients receiving AEDs [carbamazepine (CBZ), phenytoin (PHT), phenobarbital (PB), valproate (VPA)] were compared to 35 healthy controls, 12 seizure patients not taking AEDs, and 16 patients with multiple sclerosis. A structured EEG recording was conducted under controlled conditions, and subjects were tested to determine their ability to maintain wakefulness during a 6-min unstimulated trial. Testing also included Digit Symbol, auditory reaction time, and subjective measures of fatigue or sleepiness [Profile of Mood States (POMS), Stanford Sleepiness Scale (SSS)]. Patients receiving AEDs had a mean total drowsiness score of 101 s compared with ≤ 12 s for each of the three control groups (p < 0.001). One third of the AED- treated patients had > 120 s of drowsiness, in contrast to only 1 of 63 controls (p < 0.001). Among patients receiving AEDs, objective EEG drowsiness did not correlate with AED levels or performance measures. Untreated seizure patients had significantly greater complaints of lack of vigor despite a near absence of objective drowsiness on the AMT. These results suggest that epilepsy patients receiving chronic AED therapy have impaired ability to maintain wakefulness. Patient self-reports of AED-related sleepiness may not accurately represent this problem.

Original languageEnglish (US)
Pages (from-to)181-187
Number of pages7
JournalEpilepsia
Volume37
Issue number2
DOIs
StatePublished - Feb 1 1996

Keywords

  • Antiepileptic drugs
  • Drowsiness
  • Electroencephalography
  • Epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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