Document Detail


Duration of electroencephalographic recordings in patients with epilepsy.
MedLine Citation:
PMID:  23587866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Previous studies have demonstrated different diagnostic yields with electroencephalography (EEG). Due to the small sample sizes or different patient populations (outpatients or inpatients only) in these previous studies, the clinical use of routine EEG and outpatient/inpatient video-EEG monitoring (VEM) needs further clarification. In this study, we investigated EEGs obtained from patients referred by epileptologists; by comparing the results of different EEG methods, we sought to determine the optimal durations and specific types of EEG recordings for different clinical situations.
METHODS: The data from 335 routine EEGs, 281 3 h outpatient VEMs, and 247 inpatient VEMs (>48 h) were reviewed. We analyzed the latency to the first epileptiform discharge or clinical event.
RESULTS: In patients undergoing outpatient VEMs, 48% of the first epileptiform discharges appeared within 20 min, and 64% appeared within 30 min. In patients undergoing inpatient VEMs, 21.2% had their first attack within 3h. The second peak of event occurrence was during the 33rd-36th h. Only 3.5% of the seizures were recorded after 57 h. The detection rate of epileptiform discharges was higher for 3h outpatient VEM than for routine EEG (54.1% versus 16.4%, p<0.01). Epileptic and/or nonepileptic events were recorded in 45.8% of the inpatient VEMs, the diagnostic yield of which was higher than for outpatient VEMs (p<0.01). Since the patients in this study had been selected to limit the bias between each group, the diagnostic yield of EEGs in this study are likely to have been higher than those found in routine practice. Patients with generalized epilepsy had a shorter latency to the first epileptiform discharge compared to patients with localization-related epilepsy (mean, 22.1 min versus 33.9 min, p<0.05).
CONCLUSIONS: Two-thirds of epileptiform discharges were detected within 30 min of VEM. A 30-min recording is recommended for routine EEG examinations that aim to detect epileptiform discharges. A 3h outpatient VEM is a reasonable option when a routine EEG fails to detect epileptiform discharges. The latency to the first epileptiform discharge was shorter in patients with generalized epilepsy than in patients with localization-related epilepsy. 48 h of inpatient VEM might be adequate for detecting the target events.
Authors:
Chih-Hong Lee; Siew-Na Lim; Frank Lien; Tony Wu
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Publication Detail:
Type:  Journal Article     Date:  2013-04-12
Journal Detail:
Title:  Seizure     Volume:  22     ISSN:  1532-2688     ISO Abbreviation:  Seizure     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-12     Completed Date:  2014-01-23     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  438-42     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Anticonvulsants / therapeutic use
Electroencephalography*
Epilepsy / diagnosis*,  drug therapy,  physiopathology*
Evoked Potentials, Visual / physiology*
Female
Humans
Inpatients / statistics & numerical data
Male
National Health Programs / statistics & numerical data
Outpatients / statistics & numerical data
Photic Stimulation
Reaction Time
Retrospective Studies
Taiwan
Time Factors
Chemical
Reg. No./Substance:
0/Anticonvulsants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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