Editors' note: Generalized polyspike train: An EEG biomarker of drug-resistant idiopathic generalized epilepsy

In the article “Generalized polyspike train: An EEG biomarker of drug-resistant idiopathic generalized epilepsy”, Sun et al. reported the results of a case-control study with a discovery cohort and a replication cohort independently assessed at 2 centers, in which patients with idiopathic generalized epilepsy and generalized spike-wave discharges on EEG were classified as drug resistant or drug responsive. They found that the proportion of patients with generalized polyspike train (burst of generalized rhythmic spikes lasting less than 1 second) during sleep was higher in the drug-resistant group in both cohorts. In response, Drs. Rubboli and Gardella report similar EEG findings in a cohort of 12 adult patients with drug-resistant typical absences. Noting that these patients did not show any muscular activation concomitant with the generalized polyspike trains, they suggest that these trains have different pathophysiologic origins than the generalized paroxysmal fast activity seen in Lennox-Gastaut syndrome, but may share a similar dysfunction in γ-aminobutyric acid–mediated cortical inhibition as that seen with the polyspike discharges in juvenile myoclonic epilepsy. In the article “Generalized polyspike train: An EEG biomarker of drug-resistant idiopathic generalized epilepsy”, Sun et al. reported the results of a case-control study with a discovery cohort and a replication cohort independently assessed at 2 centers, in which patients with idiopathic generalized epilepsy and generalized spike-wave discharges on EEG were classified as drug resistant or drug responsive.