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Abstract Details

Acute Postictal Changes in Mood
Epilepsy/Clinical Neurophysiology (EEG)
S24 - Epilepsy Clinical Syndromes and Management (4:18 PM-4:30 PM)
005
One third of patients with newly diagnosed epilepsy have a mood disorder. Yet, the impact of seizures themselves on mood are unknown. Investigating this link may provide insights into mechanisms of depression as a comorbidity of epilepsy.
To characterize changes in mood in epilepsy patients admitted to the Epilepsy Monitoring Unit (EMU) after experiencing a seizure.

Upon admission to the NYU Langone EMU, patients with epilepsy completed the Beck Depression Inventory-II (BDI-II) and a trained assessor administered the Montgomery-Asberg Depression Rating Scale (MADRS). The MADRS was repeated 4-24 hours and 2-7 days after a seizure. Those who did not have a seizure served as controls and the MADRS was repeated from 2 days after admission to day of discharge and 2-7 days after discharge.

Out of fifty-one total subjects (Male=29; Age: M=36.4, SD=11.3), thirty-six had a seizure and fifteen were controls. There was a trend to a change in mood (measured by MADRS) in either direction post-seizure compared to post-admission for controls (Fisher’s, p=0.144). Clinically significant postictal changes in MADRS were more likely to be an improvement in mood (Fisher’s, p=0.014). Those with higher BDI-II scores were more likely to experience mood improvement 4-24 hours after a seizure (r=-0.66, p=0.0004). Conversely, controls with higher BDI-II scores were more likely to experience worsening of mood acutely post-admission (r=0.63, p=0.015). Furthermore, those with postictal mood improvement had higher BDI-II scores (M=19.6, SD=2.14 – i.e. mild depression) compared to those whose mood worsened (M=10.5, SD=2.35 – i.e. minimal depression) (One-way ANOVA, p=0.019; Tukey’s HSD, p=0.019). Nine relevant covariates (ex: inpatient therapy, length of stay, medication tapering etc.) had a lack of effect.

Seizures are associated with improvement and worsening of mood. Pre-ictal depressive symptoms predict postictal mood improvement, indicating that a subset of patients with epilepsy may experience a therapeutic effect from seizures.
Authors/Disclosures
Amit Ahituv (NYU Langone Health)
PRESENTER
Ms. Ahituv has nothing to disclose.
Maria Pleshkevich (New York University Langone) No disclosure on file
Eden Tefera, BS (NYU Langone Health) Ms. Tefera has nothing to disclose.
Anureet Kaur No disclosure on file
Claude Steriade, MD (NYU) The institution of Dr. Steriade has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for The Epilepsy Study Consortium. Dr. Steriade has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Dynamed. Dr. Steriade has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for DOJ. The institution of Dr. Steriade has received research support from NIH. Dr. Steriade has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Epitel. Dr. Steriade has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Jazz Pharmaceuticals.