4h versus 1h-nap-video-EEG monitoring in an Epileptology Unit

Abstract

Objective: To compare the performance of 4h-video EEG monitoring (VEEG) and 1h-nap-VEEG in an Epileptology Unit.

Methods: We examined short-term VEEG data from 196 patients admitted to characterize their: (i) clinical events; (ii) epileptic syndromes or (iii) state after status epilepticus or surgery. We compared the 4h-VEEG and 1h-nap-VEEG performances using three measures: (i) the capability to detect epileptic seizures (ES), psychogenic non-epileptic seizures (PNES), interictal epileptiform abnormalities (IEA) and sleep-related IEA; (ii) the usefulness to answer questions on referral; (iii) the sensitivity for the final diagnosis.

Results: The 4h-VEEG test recorded clinical events in 53.6% of 196 patients, IEA in 41.3%, sleep-related IEA in 34.7%, and was judged as useful in 66.8%. The 4h-VEEG was compared to the 1h-nap-VEEG in 129 patients. 4h-VEEG had a better capability to record clinical events (50.3% vs. 6.2%, p<0.001), a higher usefulness (63.5% vs. 37.2%, p<0.001), and a higher sensitivity for both ES (69.3% vs. 49.3%, p=0.0035) and PNES (61.3% vs. 15.4%, p=0.0014) than nap-EEG.

Conclusions: This work found 4h-VEEG records were superior to the 1h-nap-VEEG test on the basis of three complementary measures, capability, usefulness and sensitivity.

Significance: 4h-VEEG is a useful alternative investigation tool in an Epileptology Unit.

Keywords: Epilepsy; Performance; Psychogenic; Seizures; Video-EEG monitoring.