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Outpatient video-EEG monitoring in children
M B Connolly1, P K Wong, Y Karim
1Department of Pediatric Neurology, University of British Columbia, Vancouver, Canada.
Insights
Brief outpatient video-EEG monitoring effectively diagnosed epilepsy in children with frequent seizures. This method aided in classifying seizure types and determining epilepsy syndromes, proving valuable for clinical decision-making.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Video-electroencephalography (EEG) monitoring is crucial for correlating behavior with EEG activity, aiding in pseudoepileptic seizure recognition and epilepsy surgery evaluations.
- Inpatient video-EEG monitoring is often prolonged and costly.
- Frequent seizures in children necessitate accurate diagnosis and classification.
Purpose of the Study:
- To evaluate the efficacy of brief (2-3 hour) outpatient video-EEG monitoring in children with frequent seizures.
- To assess its utility in differentiating epileptic from nonepileptic events, classifying seizure types, and determining seizure frequency.
Main Methods:
- A prospective study involving 43 children with frequent seizures, primarily those with symptomatic generalized epilepsy.
- Brief (2-3 hour) outpatient video-EEG monitoring was performed.
- Clinical episodes were recorded and analyzed.
Main Results:
- Clinical episodes were captured in 83% (36/43) of children.
- A definite diagnosis was established in 9/17 patients for clinical behavior nature.
- Seizure classification was altered in 9/15 children, and epilepsy syndrome classification changed in 9 children.
- Overall, video-EEG facilitated diagnosis in 59.5% (25/43) of cases.
Conclusions:
- Brief outpatient video-EEG monitoring is an effective diagnostic tool for children experiencing frequent seizures.
- It is particularly beneficial for children with symptomatic generalized epilepsy.
- This approach aids in accurate seizure classification and diagnosis, potentially reducing healthcare costs.
Abstract:
Video-EEG monitoring enables correlation of behavioral activity with EEG activity, which is useful in recognition of pseudoepileptic seizures and in investigation of patients for epilepsy surgery. Because most patients are monitored for a prolonged time as in-patients, the cost of the procedure is high. We investigated the value of brief (2-3 h) outpatient video-EEG monitoring in 43 children with frequent seizures, most of whom had symptomatic generalized epilepsy. Indications for monitoring included differentiation of epileptic from nonepileptic behavior, seizure classification, and determination of seizure frequency. Clinical episodes were recorded in 36 of 43 children (83%). A definite diagnosis was established in 9 of the 17 patients investigated to determine the nature of the clinical behavior. Seizures were classified in 15 of the 25 patients investigated to determine seizure type, and classification was different from the original in 9 of the 15 children. A change in epilepsy syndrome classification was made in 9 children. The video-EEG allowed diagnosis in 25 of the 43 children (59.5%). Video-EEG appears to be an effective method for outpatient investigation of children with frequent seizures, particularly those with symptomatic generalized epilepsy.