Abstracts

RATIONALE: To define the diagnostic utility of video EEG in the evaluation of infants, children, and adolescents with diagnosed or suspected epilepsy.
METHODS: Charts of 120 patients referred to SchneiderChildren[ssquote]s Hospital for video EEG from January 2000 to December 2000 were retrospectively reviewed, noting whether EEG was interpreted as normal or abnormal, and whether events occurred. The following variables possibly predictive of the results of monitoring were noted: source of referral, reason for video EEG, seizure type, cognitive impairment, gender, age, treatment with antiepileptic drugs (AEDs), results of prior EEGs, number of days of monitoring, and whether AEDs were stopped.
RESULTS: Sixty-six patients had a nonepileptic event: 58% were behavioral, 8% were psychogenic, 3% were physiologic, 12% were extrapyramidal, and 9% were sleep phenomena. 17 patients had an epileptic event: 64% were generalized (convulsive and nonconvulsive), 18% were partal, and 18% were epileptic spasms. Thirty seven patients had no events. Gender, cognitive impairment, days of monitoring, and age were not associated with a greater likelihood of an epileptic event. Patients with greater than 5 events (odds ratio (OR)=3.0, p=.0043), patients with abnormal routine EEG (OR=58, p[lt].00001), and patients receiving AEDs (OR=3, p=.008) were more likely to have an abnormal video EEG.
CONCLUSIONS: The majority of events observed were nonepileptic, and of the nonepileptic events, most were behavioral. The epileptic events were mainly generalized. Predictos of an abnormal video EEG were: frequency of events, prior abnormal routine EEG, and AEDs prior to monitoring.