How do you approach ictal-interictal continuum in patients with presumed toxic/metabolic etiology?

This is a common conundrum in the EEG reading room. If during the routine EEG I get a sense that the GPDs are clearly state-dependent (i.e., more frequent in the alert state, taper off in the quiet state) and they have clear triphasic morphology, I may not do anything further aside from the recommen...