Short-term outpatient EEG-video monitoring with induction in a veterans administration population

The gold standard for diagnosis of psychogenic non-epileptic seizures (PNES) is EEG-video monitoring. EEG-video monitoring is usually prolonged and inpatient, but the availability of this procedure for veterans is limited. This study thought to evaluate the yield of short-term outpatient EEG-video monitoring for the diagnosis of PNES in a V.A. population. We reviewed the data on all short-term outpatient EEG-video monitoring performed at our V.A. hospital over a 2-year period. Short-term EEG-video monitoring was performed with induction according to a published protocol []. Briefly, induction is performed without a placebo, using hyperventilation, photic stimulation, and verbal suggestion. This was performed on patients in whom there was a clinical suspicion of PNES on clinical grounds. A total of 52 short-term EEG-video monitoring sessions were performed. Of those, 40 patients (77%) were men. In 35 patients (67%) the procedure recorded the habitual episode and resulted in a clear diagnosis of PNES. The procedure was inconclusive in 17 patients (33%), either because a non-habitual event was induced (7 patients, 14%), or no event was recorded (10 patients, 19%). The yield of EEG-video monitoring with induction in a (predominantly male) V.A. population is high, and comparable to a non-V.A. population.