Consideration of the Optimal Hospitalization Period for VEEG
Abstract number :
2.004
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2023
Submission ID :
559
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Yohei Ishishita, MD,PhD – Jichi Medical University
Keisuke Otani, MD,PhD – Neurosurgery – Jichi Medical University; Kenji Ibayashi, MD,PhD – Neurosurgery – Jichi Medical University; Takeshi Nakajima, MD,PhD – Neurosurgery – Jichi Medical University; Naoto Kunii, MD, PhD – Neurosurgery – Jichi Medical University; Kensuke Kawai, MD, PhD – Professor, Neurosurgery, Jichi Medical University
Rationale:
Video electroencephalography (VEEG) plays a crucial role in the accurate diagnosis of epilepsy by recording ictal-EEG. However, if no seizures are captured during the examination period, it becomes difficult to confirm diagnosis. The optimal examination duration for VEEG remains unclear. In this study, we investigated VEEG cases performed at our hospital to determine the optimal examination duration.
Methods:
We analyzed the cases of VEEG performed at our hospital between November 2020 and March 2023. The cases were categorized into four groups based on seizure frequency before the examination: daily (D), daily to weekly (DW), weekly to monthly (WM), and monthly or less (M). We examined the duration of the testing period, the number of days required to capture the first seizure during VEEG, and the seizure capture rate.
Results:
Consecutive 125 VEEG cases involving 118 patients (mean age 29.4±14.0 years, 62 females) were included. The average hospitalization period was 5.9±2.1 days. Seizure was captured in 89 cases (71%), leading to the following diagnosis: focal epilepsy in 52 cases (58%), generalized epilepsy in 4 cases (4%), true epilepsy + psychogenic non-epileptic seizures (PNES) in 8 cases (9%), PNES in 18 cases (20%), and other non-epileptic seizures in 5 cases (6%). In 2 cases (2%), the classification was undetermined. Based on seizure frequency before the examination, there were 12 cases (10%) in the D group, 26 cases (21%) in the DW group, 46 cases (37%) in the WM group, and 41 cases (33%) in the M group. The seizure capture rate/number of days required to capture the first seizure were as follows: D group - 83%/1.9±1.0 days, DW group - 81%/2.7±1.4 days, WM group - 80%/3.2±1.3 days, and M group - 54%/2.8±1.3 days.
Conclusions:
In the D, DW, and WM groups, approximately eighty of patients captured their first seizure within two to three days of hospitalization, allowing for a definitive diagnosis. However, for patients with PNES + true epilepsy and similar conditions, multiple seizures need to be captured, requiring careful consideration of the hospitalization period. On the other hand, the seizure capture rate in the M group was approximately 50% during five to six days of hospitalization period, indicating a lower rate. It is necessary to repeat VEEG if needed to ensure a reliable diagnosis.
Funding: None
Neurophysiology