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Neurological Sciences

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01-12-2019 | Status Epilepticus | Original Article

The clinical utility of non-invasive video-electroencephalographic monitoring has been diversifying

Authors: Yong Won Cho, Gholam K. Motamedi, Keun Tae Kim

Published in: Neurological Sciences | Issue 12/2019

Abstract

Background

Inpatient long-term video-electroencephalographic (VEEG) monitoring has been used extensively for differential diagnosis of paroxysmal events. We evaluated the diagnostic yield and clinical utility of VEEG performed in a comprehensive epilepsy center.

Method

We retrospectively reviewed all cases of VEEG performed from May 2003 to April 2018. We analyzed the data to determine its clinical utility and diagnostic yield.

Results

A total of 1335 cases were reviewed. After excluding 147 cases of intracranial recording and 163 cases with incomplete medical records, 1025 cases of VEEG were included. The mean duration of VEEG was 2.3 ± 1.6 days (range = 1–14). A total of 763 VEEGs documented epileptic seizures or interictal epileptiform discharges (IEDs) to confirm the diagnosis of epilepsy. There were 99 psychogenic non-epileptic seizure, 36 status epilepticus, and 34 VEEGs which revealed generalized or focal slow activities without any clinical seizures or IEDs. VEEG was normal in 170 cases. The diagnostic yield of VEEG varied from 83.4 to 88.4% depending on its definition. The proportion of epilepsy in total cases of VEEG continued to decrease from 77.2 to 61.4%. In contrast, the proportion of normal VEEG steadily increased from 4.1 to 24.1% during the same time period.

Conclusions

This study ascertained how useful VEEG is and the utility of VEEG has been diversifying in clinical circumstances beyond epilepsy. VEEG can play a pivotal role in the diagnostic approach to epilepsy and its differential diagnoses.

Tatum WO, Rubboli G, Kaplan PW, Mirsatari SM, Radhakrishnan K, Gloss D, Caboclo LO, Drislane FW, Koutroumanidis M, Schomer DL, Kasteleijn-Nolst Trenite D, Cook M, Beniczky S (2018) Clinical utility of EEG in diagnosing and monitoring epilepsy in adults. Clin Neurophysiol 129(5):1056–1082. https://doi.org/10.1016/j.clinph.2018.01.019 CrossRefPubMed

Burkholder DB, Britton JW, Rajasekaran V, Fabris RR, Cherian PJ, Kelly-Williams KM, So EL, Nickels KC, Wong-Kisiel LC, Lagerlund TD, Cascino GD, Worrell GA, Wirrell EC (2016) Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges. Neurology 86(16):1524–1530. https://doi.org/10.1212/wnl.0000000000002592 CrossRefPubMedPubMedCentral

Salinsky M, Kanter R, Dasheiff RM (1987) Effectiveness of multiple EEGs in supporting the diagnosis of epilepsy: an operational curve. Epilepsia 28(4):331–334CrossRef

Marsan CA, Zivin LS (1970) Factors related to the occurrence of typical paroxysmal abnormalities in the EEG records of epileptic patients. Epilepsia 11(4):361–381CrossRef

Baldin E, Hauser WA, Buchhalter JR, Hesdorffer DC, Ottman R (2014) Yield of epileptiform electroencephalogram abnormalities in incident unprovoked seizures: a population-based study. Epilepsia 55(9):1389–1398. https://doi.org/10.1111/epi.12720 CrossRefPubMedPubMedCentral

Gregory RP, Oates T, Merry RT (1993) Electroencephalogram epileptiform abnormalities in candidates for aircrew training. Electroencephalogr Clin Neurophysiol 86(1):75–77CrossRef

So EL (2010) Interictal epileptiform discharges in persons without a history of seizures: what do they mean? J Clin Neurophysiol 27(4):229–238. https://doi.org/10.1097/WNP.0b013e3181ea42a4 CrossRefPubMed

Benbadis SR, Lin K (2008) Errors in EEG interpretation and misdiagnosis of epilepsy. Which EEG patterns are overread? Eur Neurol 59(5):267–271. https://doi.org/10.1159/000115641 CrossRefPubMed

Benbadis SR, O’Neill E, Tatum WO, Heriaud L (2004) Outcome of prolonged video-EEG monitoring at a typical referral epilepsy center. Epilepsia 45(9):1150–1153. https://doi.org/10.1111/j.0013-9580.2004.14504.x CrossRefPubMed

10.

Binnie CD, Rowan AJ, Overweg J, Meinardi H, Wisman T, Kamp A, Lopes da Silva F (1981) Telemetric EEG and video monitoring in epilepsy. Neurology 31(3):298–303CrossRef

11.

Shih JJ, Fountain NB, Herman ST, Bagic A, Lado F, Arnold S, Zupanc ML, Riker E, Labiner DM (2018) Indications and methodology for video-electroencephalographic studies in the epilepsy monitoring unit. Epilepsia 59(1):27–36. https://doi.org/10.1111/epi.13938 CrossRefPubMed

12.

Ghougassian DF, d’Souza W, Cook MJ, O’Brien TJ (2004) Evaluating the utility of inpatient video-EEG monitoring. Epilepsia 45(8):928–932. https://doi.org/10.1111/j.0013-9580.2004.51003.x CrossRefPubMed

13.

Mohan KK, Markand ON, Salanova V (1996) Diagnostic utility of video EEG monitoring in paroxysmal events. Acta Neurol Scand 94(5):320–325CrossRef

14.

Kumar-Pelayo M, Oller-Cramsie M, Mihu N, Harden C (2013) Utility of video-EEG monitoring in a tertiary care epilepsy center. Epilepsy Behav 28(3):501–503. https://doi.org/10.1016/j.yebeh.2013.06.015 CrossRefPubMed

15.

Alving J, Beniczky S (2009) Diagnostic usefulness and duration of the inpatient long-term video-EEG monitoring: findings in patients extensively investigated before the monitoring. Seizure 18(7):470–473. https://doi.org/10.1016/j.seizure.2009.04.005 CrossRefPubMed

16.

Jin B, Zhao Z, Ding Y, Guo Y, Shen C, Wang Z, Tang Y, Zhu J, Ding M, Wang S (2014) Diagnostic yield of inpatient video-electroencephalographic monitoring: experience from a Chinese comprehensive epilepsy center. Epilepsy Behav 34:77–80. https://doi.org/10.1016/j.yebeh.2014.03.010 CrossRefPubMed

17.

Sutter R, Fuhr P, Grize L, Marsch S, Ruegg S (2011) Continuous video-EEG monitoring increases detection rate of nonconvulsive status epilepticus in the ICU. Epilepsia 52(3):453–457. https://doi.org/10.1111/j.1528-1167.2010.02888.x CrossRefPubMed

18.

Theitler J, Dassa D, Gandelman-Marton R (2017) The yield of non-elective inpatient video-EEG monitoring in adults. Neurol Sci 38(6):961–965. https://doi.org/10.1007/s10072-017-2872-2 CrossRefPubMed

Title: The clinical utility of non-invasive video-electroencephalographic monitoring has been diversifying
Authors: Yong Won Cho
Gholam K. Motamedi
Keun Tae Kim
Publication date: 01-12-2019
Publisher: Springer International Publishing
Keywords: Status Epilepticus
Electroencephalography
Epilepsy
Non-Epileptic Seizure
Epileptic Seizure
Published in: Neurological Sciences / Issue 12/2019
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-019-04022-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The clinical utility of non-invasive video-electroencephalographic monitoring has been diversifying

Abstract

Background

Method

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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