Abstracts

Rationale: The objective of our study is to emphasize the importance of intensive video EEG monitoring in special circumstances in patients with well-established diagnosis of epilepsy. The idea is to diagnose new onset frequent events associated with change in ictal semiology prompting the need for frequent emergency room visits and hospital admissions. Methods: Retrospective chart reviews were conducted on patients with intractable epilepsy who had increased incidence of new onset episodes different from the baseline ictal semiology. Patients were admitted to Scott & White Hospital/Texas A&M Health Science Center, Temple, TX for intensive video EEG monitoring from 2008 to 2011. Data were acquired from electronic medical records. Approval for this retrospective analysis of patient records was given by the hospital's Institutional Review Board. Results: We retrospectively analyzed 14 patients with an established diagnosis of intractable epilepsy. Extensive chart reviews were performed with emphasis on type and duration of epilepsy, extent of interictal epileptiform abnormalities on EEG, failed and current treatment regimens, baseline frequency and semiology of seizures. The study population consisted of 14 patients (mean age: 43 years, range: 21-67 years). There were 10 women (71.5 %) and 4 men (28.5 %). Eleven patients (78.6 %) had partial and 3 (28.4%) had generalized epilepsy. The patients were on an average of three antiepileptic medicines (range 1-5). The duration of follow up in our neurology clinic ranges from 9 months to 9 years. The occurrence of increased frequency from the baseline associated with change in semiology of the seizures, despite therapeutic anticonvulsant levels, prompted the need for 5-day intensive video EEG monitoring. Atypical spells were documented in all patients and were without any ictal correlate. Conclusions: Our data analysis showed that intensive video EEG monitoring is an important tool to evaluate change in frequency and ictal semiology of seizures even in patients with an established diagnosis of intractable epilepsy.