Abstracts

RATIONALE: Treatment with AED for EEG abnormality with no seizure is controversial. However, some patients present with persistent short term memory difficulty with no history of seizure but have interictal epileptiform discharges in EEG. Assuming that the patients are symptomatic due to the EEG abnormality, we have tried low dose AED treatment to confirm its clinical relevancy of the EEG finding. METHODS: Six patients (age 37 to 80) were identified who visited with a chief complaint of persistent short term memory difficulty. EEG evaluations showed interictal temporal lobe discharges. None of them had a previous history of seizure, syncope, depression or dementia. Their mental status examinations were all normal except short term memory deficit. These patients were treated with AED monotherapy and followed in our outpatient clinic. RESULTS: 4 of the six patients had left temporal sharp discharges, and 2 had bitemporal sharp discharges in the routine EEG study. None of them had hippocampal abnormality by MRI. All of the patient experienced subjective improvement of short term memory by AED monotherapy. 4/6 have significant improvement and 2/6 had mild improvement. CONCLUSIONS: Unlike epileptic amnestic syndrome, these cases never experienced seizure spells or paroxysmal mental status changes. Treatment with low dose AED monotherapy was benefitial. Observation of these cases are suggestive of a different category of amnestic syndrome associated with EEG abnormality which may be easily improved by AED monotherapy.