Characteristics of Patients Undergoing Long-Term-EEG Monitoring with Documented Seizure Activity and Absent Interictal Spikes.
Abstract number :
H.07
Submission category :
Year :
2000
Submission ID :
749
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Olaf Stuve, Carl B Dodrill, Mark D Holmes, John W Miller, Univ of Washington, Regional Epilepsy Ctr, Seattle, WA.
RATIONALE: To determine the demographic, clinical, EEG, and imaging characteristics of patients undergoing long-term-EEG monitoring who had documented ictal seizure activity and absent interictal spikes. METHODS: Retrospective analysis of an electronic database containing information about 1223 patients between 1991 to date, identified subjects who received noninvasive long-term video EEG monitoring as inpatients between 24 hours and 168 hours (mean: 126 hours). A search was made for patients with at least one epileptic seizure recorded who had no interictal spiking anywhere in their records. RESULTS: In total, 26 patients were identified. The mean age of patients was 32 years (range 17 to 62 years). 14 patients were male, and 12 patients were female. 85% of patients were right handed, and 15% left handed. The mean Verbal IQ was 91, the mean Performance IQ was 92, and the mean Full Scale IQ was 88. A family history of seizures was positive in 19%, and 12% of patients had a history of febrile seizures. 42% of patients had a psychiatric history, and 62% had a positive neurological diagnosis other than epilepsy. 15% of patients had a focal neurological deficit on physical examination. The most common seizure type was simple partial seizure with a prevalence of 42%, followed by complex partial seizures with a prevalence of 35%. The most common first line therapy was phenytoin, which was taken by 42% of patients. 34% of patients had a fronto-temporal ictal focus, 12% had a basal-temporal ictal focus, and 12% had a mid-temporal ictal focus. Imaging studies of the brain were obtained in 54% of patients. 64% of those studies were normal, 21% showed a frontal lesion, 14% showed a parietal lesion, and 7% showed a fronto-temporal lesion. CONCLUSIONS: Only 2% of patients in our database who had at least one epileptic seizure recorded with noninvasive long-term EEG monitoring had no interictal spiking anywhere in their records. No patient had primary generalized tonic-clonic seizures as the primary seizure type. Surprisingly, the most common seizure type was simple partial seizure. Furthermore, the presence of basal-temporal ictal foci was rare.