Monitoring at the Swiss Epilepsy Center

Long-term monitoring facilities have proven irreplaceable in the investigation of epileptic patients as well as in the assessment of therapy. We describe an integrated monitoring system which has been in operation in our center for over 5 years. It includes long-term monitoring by means of a 21-channel EEG write-out and video taping, ambulatory monitoring using a 4-channel cassette as well as an intensive monitoring system combining 16-channel radio telemetered EEG with split-screen video technology. Technical equipment, organization, indications, applications and clinical results are presented in detail. The availability of an experienced team of specialists (neurologist, engineer, clinical pharmacologist, neuropsychologist) is a prerequisite for the optimal utilization of these facilities. With out integrated monitoring system we investigate an average of 550 patients/year. In over half the cases, the desired information can be provided, resulting in a direct therapeutic benefit. The additional value of these methods, especially of the intensive monitoring, lies also in the possibility of compiling new knowledge about semiology and electro-clinical correlation of epileptic seizures, possible trigger mechanisms and long-term therapeutic effects. This should help to better understand the underlying pathophysiology and to further reduce the number of epileptic patients not responding to therapy.