Abstracts

To find out the various diagnostic roles of video-EEG monitoring (VEM) and assess the patient[apos]s outcome after VEM., We included 1528 consecutive patients who underwent VEM in the adult epilepsy section of Seoul National University Hospital. We classified the purposes of VEM and assessed the patients[apos] status after VEM or epilepsy surgery guided by VEM. The minimum follow-up period was more than one year after VEM or surgery., The mean age at VEM was 29.7 years and the mean monitoring days were 4.5 days. The most common purposes of VEM were presurgical evaluations (67.3%), confirmation of epilepsy (15.8%), classification of seizures (9.3%), and diagnosis of pseudoseizure (5.5%). The common interventions after VEM were change or initiation of antiepileptic drugs (AED) (720 patients, 47.3%), and epilepsy surgery (534 patients, 34.9%). The frequently diagnosed epileptic syndromes after VEM were medial and lateral TLE (48.2%), frontal lobe epilepsy (18.4%), occipital lobe epilepsy (5.9%), parietal lobe epilepsy (5.5%), and juvenile myoclonic epilepsy (2.9%). Pseudoseizure was confirmed by VEM in 72.6% of pseudoseizure-suspected patients. The applied surgical procedures were standard anterior temporal lobectomy or selective amygdalohipocampectomy (272 patients), neocortical resection including lesionectomy (248), corpus callosotomy (10), and functional hemispherectomy (4). 698 of 1260 patients whose outcome could be assessed at more than one year follow-up after VEM or epilepsy surgery guided by VEM were seizure free. The outcome was significantly better in surgical group than in AED group (P[lt]0.0001). 373 out of 534 patients with were seizure-free after epilepsy surgery while only 324 out of 719 patients with change or addition of AED became seizure free. However, only 489 (ncluding 373 seizure-free patients after surgery) of 930 patients whose original purpose was epilepsy surgery tbecame seizure free. Furthermore, the best outcome was observed in the patients in whom the purpose of VEM was classification of seizures., VEM is a useful tool for various purposes. The patients[apos] outcome was dependent on purposes of VEM as well as the treatment modalities after VEM.,