Clinical utility of sleep-deprived versus computer-assisted ambulatory 16-channel EEG in epilepsy patients: a multi-center study
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Published on: December 22, 2016
J Liporace1, W Tatum, G L Morris
1Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. Joyce.Liporace@mail.tju.edu
Purpose:
The objective of this prospective study was to compare the usefulness of a sleep-deprived electroencephalogram (EEG) versus a computer-assisted 16-channel ambulatory EEG in patients with historical information consistent with epilepsy but with a normal or non-diagnostic initial routine EEG.
Methods:
A total of 46 patients had both a 30-60 min sleep-deprived EEG and a computer-assisted ambulatory 24 h EEG. Each EEG was assigned a number and reviewed independently by two board-certified electroencephalographers for the presence of interictal epileptiform discharges and seizures.
Results:
Both the sleep-deprived EEG and ambulatory EEG improved detection of epileptiform discharges by a similar amount (24% versus 33%); however, the ambulatory EEG detected seizures in 7/46 (15%) patients, and in three patients the seizures were solely detected by the computer.
Conclusions:
we conclude that the computer-assisted ambulatory EEG offers greater benefit than a sleep-deprived recording because in addition to detecting interictal epileptiform discharges, it may also capture seizures. The discovery of unsuspected seizures can significantly impact clinical management.
