4h versus 1h-nap-Video-EEG monitoring in an Epileptology Unit

Publication date: Available online 18 June 2016
Source:Clinical Neurophysiology
Author(s): Vi-Huong Nguyen-Michel, Vera Dinkelacker, Ovidio Solano, Pierre-P. Levy, Virginie Lambrecq, Claude Adam, Sophie Dupont, Lionel Naccache, Emmanuel Fournier, Michel Baulac, Vincent Navarro
ObjectiveTo compare the performance of 4h-video EEG monitoring (VEEG) and 1h-nap-VEEG in an Epileptology Unit.MethodsWe examined short-term VEEG data from 196 patients admitted to characterize their: (i) clinical events; (ii) epileptic syndromes or (iii) state after status epilepticus or surgery. We compared the 4h-VEEG and 1h-nap-VEEG performances using three measures: (i) the capability to detect epileptic seizures (ES), psychogenic non-epileptic seizures (PNES), interictal epileptiform abnormalities (IEA) and sleep-related IEA; (ii) the usefulness to answer questions on referral; (iii) the sensitivity for the final diagnosis.ResultsThe 4h-VEEG test recorded clinical events in 53.6% of 196 patients, IEA in 41.3%, sleep-related IEA in 34.7%, and was judged as useful in 66.8%. The 4h-VEEG was compared to the 1h-nap-VEEG in 129 patients. 4h-VEEG had a better capability to record clinical events (50.3 vs 6.2%, p<0.001), a higher usefulness (63.5 vs 37.2%, p<0.001), and a higher sensitivity for both ES (69.3 vs 49.3%, p=0.0035) and PNES (61.3 vs 15.4%, p=0.0014) than nap-EEG.ConclusionsThis work found 4h-VEEG records were superior to the 1h-nap-VEEG test on the basis of three complementary measures, capability, usefulness and sensitivity.Significance4h-VEEG is a useful alternative investigation tool in an Epileptology Unit.



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