Parietal theta rhythms in carbamazepine therapy of children with epilepsy
UNLABELLED Regional bioelectrical activity changes presenting as prolonged or periodic inhibition at the central parietal leads in theta rhythm (PT) are regarded in some studies as congenital predisposition to epilepsy. The study estimates a carbamazepine (CBM) therapy efficacy in children with epilepsy with- or without PT. To study the prognosis in CBM therapy, 119 patients, 63 with PT (group 1) and 56--without PT (group 2) have been retrospectively examined. Patients with the presence of generalized spike-and-wave activity (SWA) before CBM treatment have been excluded from the study. Despite the insignificant between-group differences of clinical and EEG-data before the therapy beginning, the CBM response was much worse in the group 1: a marked effect was found in 14 (22%) patients, in 41 (65%) the effect was mild or absent at all, and in 8 (13%) a disease course worsening was detected. In group 2 a good effect was in 42 (75%) patients, no effect was detected in 14 (25%) patients and none of the patients was worse. Correlations between SWA appearance and inadequate CBM action, as well as between improvement/worsening absence of EEG and favorable prognosis during therapy have been found. CONCLUSIONS Carbamazepine efficacy in the children with epilepsy is significantly lower in the presence of parietal theta rhythm. PT is likely to be a liability factor for SWA appearance during CBM therapy.