4 h versus 1 h-nap-video-EEG monitoring in an Epileptology Unit. Issue 9 (September 2016)

• Record Type: Journal Article
• Authors: Nguyen-Michel, Vi-Huong; Dinkelacker, Vera; Solano, Ovidio; Levy, Pierre-P.; Lambrecq, Virginie; Adam, Claude; Dupont, Sophie; Naccache, Lionel; Fournier, Emmanuel; Baulac, Michel; Navarro, Vincent
• Is Part Of: Clinical neurophysiology. Volume 127:Issue 9(2016:Sep.)
• Page Start: 3135
• Page End: 3139
• Publication Date: 2016-09
• Subjects: IEA interictal epileptiform abnormalities -- ES epileptic seizures -- PNES psychogenic non-epileptic seizures -- VEEG video-EEG monitoring; Video-EEG monitoring -- Epilepsy -- Psychogenic -- Seizures -- Performance; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2016.06.008
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Capability, usefulness and sensitivity were studied to access the performances of short-term VEEG. 4 h-VEEG showed better performances than 1 h-nap-VEEG. The distinct clinical roles for 4 h-VEEG and 1 h-nap-VEEG are discussed. Abstract: Objective: To compare the performance of 4 h-video EEG monitoring (VEEG) and 1 h-nap-VEEG in an Epileptology Unit. Methods: We examined short-term VEEG data from 196 patients admitted to characterize their: (i) clinical events; (ii) epileptic syndromes or (iii) state after status epilepticus or surgery. We compared the 4 h-VEEG and 1 h-nap-VEEG performances using three measures: (i) the capability to detect epileptic seizures (ES), psychogenic non-epileptic seizures (PNES), interictal epileptiform abnormalities (IEA) and sleep-related IEA; (ii) the usefulness to answer questions on referral; (iii) the sensitivity for the final diagnosis. Results: The 4 h-VEEG test recorded clinical events in 53.6% of 196 patients, IEA in 41.3%, sleep-related IEA in 34.7%, and was judged as useful in 66.8%. The 4 h-VEEG was compared to the 1 h-nap-VEEG in 129 patients. 4 h-VEEG had a better capability to record clinical events (50.3% vs. 6.2%, p < 0.001), a higher usefulness (63.5% vs . 37.2%, p < 0.001), and a higher sensitivity for both ES (69.3% vs. 49.3%, p = 0.0035) and PNES (61.3% vs. 15.4%, p = 0.0014) than nap-EEG. Conclusions: This work found 4 h-VEEG records were superior to the 1 h-nap-VEEG test on the basis of three complementary measures, capability, usefulness and sensitivity. Significance: 4 h-VEEG is a useful alternative investigation tool in an Epileptology Unit.