Neurophysiological investigations for the diagnosis of non-epileptic attack disorder in neuropsychiatry services: from safety standards to improved effectiveness. Issue 4 (23rd March 2016)

• Record Type: Journal Article
• Authors: Cavanna, Andrea E.; Seri, Stefano
• Is Part Of: Acta neuropsychiatrica. Volume 28:Issue 4(2016:Aug.)
• Page Start: 185
• Page End: 194
• Publication Date: 2016-03-23
• Subjects: epilepsy, -- neuropsychiatry, -- non-epileptic attack disorder, -- safety, -- video-EEG telemetry; Neuropsychiatry -- Periodicals; 616.89
• DOI: 10.1017/neu.2016.10
• Languages: English
• ISSNs: 0924-2708

Abstract

Abstract : Objective: The discipline of clinical neuropsychiatry currently provides specialised services for a number of conditions that cross the traditional boundaries of neurology and psychiatry, including non-epileptic attack disorder. Neurophysiological investigations have an important role within neuropsychiatry services, with video-electroencephalography (EEG) telemetry being the gold standard investigation for the differential diagnosis between epileptic seizures and non-epileptic attacks. This article reviews existing evidence on best practices for neurophysiology investigations, with focus on safety measures for video-EEG telemetry. Methods: We conducted a systematic literature review using the PubMed database in order to identify the scientific literature on the best practices when using neurophysiological investigations in patients with suspected epileptic seizures or non-epileptic attacks. Results: Specific measures need to be implemented for video-EEG telemetry to be safely and effectively carried out by neuropsychiatry services. A confirmed diagnosis of non-epileptic attack disorder following video-EEG telemetry carried out within neuropsychiatry units has the inherent advantage of allowing diagnosis communication and implementation of treatment strategies in a timely fashion, potentially improving clinical outcomes and cost-effectiveness significantly. Conclusion: The identified recommendations set the stage for the development of standardised guidelines to enable neuropsychiatry services to implement streamlined and evidence-based care pathways.