Virtual car accidents of epilepsy patients, interictal epileptic activity, and medication.

Nirkko, Arto Christian; Bernasconi, Corrado Angelo; von Allmen, Andreas; Liechti, Christian; Mathis, Johannes; Krestel, Heinz Eric (2016). Virtual car accidents of epilepsy patients, interictal epileptic activity, and medication. Epilepsia, 57(5), pp. 832-840. Wiley-Blackwell 10.1111/epi.13361

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OBJECTIVE To investigate effects of interictal epileptic activity (IEA) and antiepileptic drugs (AEDs) on reactivity and aspects of the fitness to drive for epilepsy patients. METHODS Forty-six adult patients with demonstration of focal or generalized bursts of IEA in electroencephalography (EEG) readings within 1 year prior to inclusion irrespective of medication performed a car driving computer test or a single light flash test (39 patients performed both). Reaction times (RTs), virtual crashes, or lapses (RT ≥ 1 s in the car or flash test) were measured in an IEA burst-triggered fashion during IEA and compared with RT-measurements during unremarkable EEG findings in the same session. RESULTS IEA prolonged RTs both in the flash and car test (p < 0.001) in individual patients up to 200 ms. Generalized IEA with spike/waves (s/w) had the largest effect on RT prolongation (p < 0.001, both tests), whereas mean RT during normal EEG, age, gender, and number of AEDs had no effect. The car test was better than the flash test in detecting RT prolongations (p = 0.030). IEA increased crashes/lapses >26% in sessions with generalized IEA with s/w. The frequency of IEA-associated RT >1 s exceeded predictions (p < 0.001) based on simple RT shift, suggesting functional impairment beyond progressive RT prolongation by IEA. The number of AEDs correlated with prolonged RTs during normal EEG (p < 0.021) but not with IEA-associated RT prolongation or crashes/lapses. SIGNIFICANCE IEA prolonged RTs to varying extents, dependent on IEA type. IEA-associated RTs >1 s were more frequent than predicted, suggesting beginning cerebral decompensation of visual stimulus processing. AEDs somewhat reduced psychomotor speed, but it was mainly the IEA that contributed to an excess of virtual accidents.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Nirkko, Arto Christian; Bernasconi, Corrado Angelo; Mathis, Johannes and Krestel, Heinz Eric

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0013-9580

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

28 Jul 2016 15:36

Last Modified:

20 Sep 2017 21:57

Publisher DOI:

10.1111/epi.13361

PubMed ID:

27043034

Uncontrolled Keywords:

Antiepileptic drugs; Driving simulator; Fitness to drive; Patient safety; Reactivity

BORIS DOI:

10.7892/boris.84416

URI:

https://boris.unibe.ch/id/eprint/84416

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