Ambulatory EEG, an Invaluable Adjunct to Evaluation of Spells Concerning for Seizure: A Case Report
Abstract number :
2.221
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2024
Submission ID :
6
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Magdalena Warzecha, BS, R.EEG/EP, CLTM, NA-CLTM, FASET – Neurotech
Tomi Ashaye, MD – Neurotech/ UT Health
Rationale: While Epilepsy Monitoring Unit (EMU) evaluation is the gold standard for accurate diagnosis of spells concerning for seizures, an EMU admission is often not feasible for a myriad of reasons. Ambulatory EEG mitigates many of the limitations and should be considered even after extensive work up, if the clinical suspicion for seizures remains.
Methods: We present the case of a 55-year-old man with extensive cardiovascular history and psychological trauma with the diagnosis of non-epileptic spells for 3 years. Prior multi-day Video EEGs were reportedly normal, but none captured habitual episodes.
Results: An ambulatory EEG captured two clinical and electrographic seizures confirming the diagnosis of bilateral temporal lobe epilepsy. The seizures were associated with bradycardia and a 9 second episode of asystole was captured with the seizure that originated from the left temporal lobe.
Conclusions: The patient's concomitant cardiac and psychological history provided alternative explanations for the episodes. Without the ambulatory EEG, his epilepsy would have remained undiagnosed. This case highlights the vital role that ambulatory EEG plays both in the diagnosis of epilepsy and in uncovering the cardiac sequalae that could have resulted in death (SUDEP).
Funding: none
Clinical Epilepsy