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Is long-term electroencephalogram more appropriate than standard electroencephalogram in the elderly?
M Chochoi1, L Tyvaert1, P Derambure2
1Epilepsy Unit, Lille University Hospital, Lille, France.
Summary
Long-term video electroencephalogram (lt-EEG) significantly improves the detection of epileptiform activity in elderly patients with suspected non-convulsive seizures compared to standard EEG. Lt-EEG is recommended for this patient population due to its superior diagnostic yield.
Area of Science:
- Neurology
- Clinical Neurophysiology
Background:
- Elderly patients with suspected non-convulsive seizures often present diagnostic challenges.
- Standard electroencephalogram (EEG) may have limited sensitivity in detecting subtle epileptiform discharges.
Purpose of the Study:
- To compare the diagnostic accuracy of standard EEG (st-EEG) versus long-term video EEG (lt-EEG) in elderly individuals with suspected non-convulsive seizures.
Main Methods:
- A prospective study of 43 hospitalized elderly patients (over 65) undergoing lt-EEG for suspected non-convulsive seizures.
- st-EEG was defined as the initial 20 minutes of each lt-EEG recording.
- Clinical, imaging, and diagnostic data were collected and analyzed.
Main Results:
- Epileptiform discharges were detected in 28% of patients with lt-EEG versus only 7% with st-EEG (p=0.004).
- Non-convulsive seizures were recorded in 4 cases with lt-EEG compared to 1 with st-EEG.
- Dementia was associated with a positive lt-EEG finding (p=0.047).
Conclusions:
- Lt-EEG demonstrates superior diagnostic accuracy for detecting epileptiform activity in elderly patients with suspected non-convulsive seizures.
- st-EEG has a low diagnostic yield in this population, making lt-EEG the preferred method.
