Abstracts

Inpatient video-EEG monitoring is widely used for diagnostic and pre-surgical evaluation of patients suspected of having epilepsy. However, few studies have systematically assessed its utility: hence the justification for the resources consumed continues to be debated. The purpose of this study was to examine the utility of inpatient video-EEG monitoring in altering the diagnoses and management of patients.
A retrospective analysis of records of patients admitted over a three-year period to an inpatient video-EEG monitoring unit in a tertiary referral hospital was performed.
Of 131 patients, 91 (70%) were admitted for diagnostic evaluation, 30 (23%) for a pre-surgical work-up and 9 (7%) had diagnostic and surgical questions to be answered. Mean evaluative period was 5.6 days. The mean numbers of seizures recorded were 2.9. No seizures were recorded in 31% of patients. The prolonged interictal EEG recording showed epileptiform discharges in 43 (33%). In 76 (58%) the diagnos was altered following the telemetry; with the greatest change being an increase in the [quot]non-epileptiform[quot] category (7% to 31%). Post VEM management was changed in 73.
Inpatient video-EEG monitoring has a high yield in changing diagnose and management. Future follow-up studies examining the long-term cost-benefit and effect on quality of life of these management changes will aid in further cementing the role of VEM in management of such patients.
[Supported by: Drs Ghougassian and D[apos]souza were supported by an Epilepsy Fellowship Sponsored by Parke-Davis, Division of Pfizer.]