Abstracts

Rationale: To identify patients most likely to have clinical seizures, as well as those with more subtle presentations (i.e., altered mental status, behavioral changes) documented on continous VEEG monitoring. Methods: Two hundred and fifty patients who underwent VEEGs were studied retrospectively out of the total of three hundred seventy-one VEEG admissions during the study period of one year in pediatric neurology at the Children's Hospital of NJ at Newark Beth Israel Medical Center. All VEEG obtained in 2009 on patients under 18 years were reviewed; no exclusion criteria (no patients were disqualified if data was in records). The total number of monitoring days was seven hundred thirty-seven and the length of stay was approximately 48 hours. The common indications for VEEG during the study period were: 1) New onset unprovoked events, 2) Status epilepticus/altered mental status, 3) Classification of seizures and epileptic syndrome, 4) Adjustment of treatment /new treatment with anti-epileptic drugs(AED), 5) Response to treatment/quantification of seizures, and 6) Withdrawal of medications (AEDs). Results: Of the 250 patients studied 100 were reported normal(40%). Abnormal background was seen in 86(34.6%). Seizures were noted in 82(32.8%) and 77(30.8%) were non-epileptic. Conclusions: VEEG monitoring is very important to diagnose epilepsy correctly, along with type of seizure and epileptic syndromes as early as possible, especially non-convulsive seizures as the excessive demand and increased blood flow associated with ictal activity may further compromise at-risk brain tissue following acute brain insult. Also it is important to differentiate non-epileptic events (e.g., in our study there were 30%) and treat them appropiately to avoid unnecessary exposure to anti-epileptic drugs(AED).