Clinical benefits of scalp EEG studies in intractable seizure disorders

Intractable seizure disorder is a clinical as well as a diagnostic problem. We evaluated the clinical role of extensive EEGs among patients (n = 64) considered to suffer from intractable paroxysmal neurologic symptoms. By reducing antiepileptic medication, ictal events were recorded in 89% of the cases. From the clinical point of view, intensive EEG-videomonitoring (IVM) was superior to all the other EEG studies. Combined interictal routine EEG (rEEG) and ictal ambulatory EEG (aEEG) findings proved to be surprisingly successful, in some clinical settings equal to IVM. Comprehensive EEG investigations and subsequent treatment in a neurologic ward resulted in proper medication and markedly improved seizure control, confirmed by a prospective clinical follow-up of two years.