VIDEO EEG TELEMETRY PROVES THE BEST CAN BE WRONG
Abstract number :
1.107
Submission category :
Year :
2002
Submission ID :
1980
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Catherine Thieman, Taoufik M. Alsaadi, Masud Seyal. Neurology, University of California, Davis, Sacramento, CA; Neurology, University of California, Davis, Sacramento, CA; Neurology, University of California, Davis, Sacramento, CA
RATIONALE: To examine the usefulness of video EEG telemetry for patients with spells of unclear etiology who were referred by a neurologist with experience in epilepsy or an epileptologist. At the end of this study we were able to evaluate how frequently a patients diagnosis changed after reviewing the video EEG telemetry findings.
METHODS: We retrospectively reviewed the charts of 49 adult patients consecutively admitted to our epilepsy monitoring unit during the period of July 31, 2001 to April 14, 2002. We excluded patients who were admitted for epilepsy surgery monitoring. The charts were reviewed for demographic and clinical data that lead to the initial referral for telemetry by a neurologist or epileptologist, this includes age of onset, interictal EEGs, and imaging studies (including MRIs).
RESULTS: Of the patients admitted for evaluation of spells of unclear etiology, a diagnosis of epileptic seizures was made in five of the patients who were initially felt to have non-epileptic seizures. The diagnosis of non-epileptic seizures was made in 11 patients who were initially felt to have epileptic seizures. Misclassification of epilepsy syndrome was found in three patients who were strongly felt to have epileptic seizures by the referring neurologist or epileptologist. Of those misclassified, two who were believed to have partial epilepsy, had generalized epilepsy, and one diagnosed as generalized epilepsy had partial epilepsy. Prior to video EEG telemetry, six out of the 11 patients with non-epileptic seizures were strongly believed to have epileptic seizures. Their histories were suggestive of epilepsy because of risk factors that would increase the likelihood of seizures, and/or abnormal interictal EEG.
CONCLUSIONS: Video EEG telemetry is crucial in establishing a diagnosis in patients with epilepsy. Without video EEG telemetry patients can be misclassified or receive ineffective treatment for epilepsy, even when being treated by the most experienced hands. With video EEG telemetry, therapy can be improved to achieve the best possible results for our patients.