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The yield of non-elective inpatient video-EEG monitoring in adults

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Abstract

Background

Inpatient video-EEG monitoring (VEM) can contribute to the diagnosis and treatment in many of the monitored patients. Most admissions to VEM are elective and are scheduled ahead before the monitoring session.

Purpose

To retrospectively evaluate the yield of non-elective VEM sessions.

Methods

We retrospectively reviewed the VEM recordings and medical records of all the patients admitted to our one-bed VEM unit from June 2007 to June 2015. A VEM session was diagnostic when a seizure, an event or previously unreported interictal epileptiform discharges were recorded.

Results

The study group included 304 adults aged 18–92 years (mean 40.4 ± 17.4 years), 181 (59%) women. The diagnostic yield of non-elective and elective VEM session was similar (66 and 69%, respectively). In non-elective VEM, fewer patients had known epilepsy (p = 0.0001), session duration was shorter (p = 0.0001), and seizures and interictal epileptiform discharges were recorded less frequently compared to elective VEM (p = 0.005 and p = 0.0001, respectively).

Conclusion

Non-elective VEM can provide useful information in patients admitted to the neurology department with recent neurological or behavioral events. A timely and correct diagnosis in these patients can potentially reduce unnecessary use of antiepileptic drugs in patients with psychogenic nonepileptic seizures and the morbidity and mortality associated with undiagnosed seizures.

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Acknowledgements

We thank Ilana Gelernter, M.A., from the statistical laboratory in the School of Mathematics, for the statistical analysis.

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Correspondence to Revital Gandelman-Marton.

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Additional information

The abstract was presented in the 10th World Congress on Controversies in Neurology, Lisbon, 2016.

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Theitler, J., Dassa, D. & Gandelman-Marton, R. The yield of non-elective inpatient video-EEG monitoring in adults. Neurol Sci 38, 961–965 (2017). https://doi.org/10.1007/s10072-017-2872-2

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  • DOI: https://doi.org/10.1007/s10072-017-2872-2

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