Abstracts

Rationale: Long-term video-EEG monitoring (VEEG) is the most important examination in the comprehensive evaluation of epilepsy. It is also useful to differentiate non-epileptic paroxysmal events from epileptic seizures. VEEG is repeated in the same patient sometimes, however it is not fully understood what kind of patients has the clinical significance of repeating a VEEG. Methods: We performed a comprehensive evaluation of epilepsy including VEEG on a total of 747 patients in our hospital from 2010 to 2017. Of those, patients who underwent VEEG more than twice were recruited. Exclusion criteria were post-surgical cases and follow-up cases with seizure freedom. The final sample for this study included 36 patients (14 males and 22 females, aged 15-72 years old). All 36 patients underwent VEEG twice. The diagnosis, clinical course, and VEEG data were retrospectively reviewed to evaluate the value of repeating a VEEG. Results: The median time interval between the first and second VEEG was 2.5 years. The reasons for the second VEEG evaluation were divided into the following: (1) reevaluation of surgical indication for 21 patients who were diagnosed with pharmacoresistant focal epilepsy, (2) evaluation of new-onset events for 10 patients who were diagnosed with epilepsy, and (3) reevaluation of lasting paroxysmal events for 5 patients who were suspected as non-epilepsy. The achievements of the second VEEG in each group were the following: (1) recording of new interictal and/or ictal epileptiform discharges in 8 out of 21 patients, which provided no surgical indication, (2) recording of new-onset events in 8 out of 10 patients, which provided the confirmation of epilepsy or comorbidity, and (3) recording of interictal and/or ictal epileptiform discharges in 3 out of 5 patients, which provided the change of diagnosis from non-epilepsy to epilepsy. Conclusions: Repeating a VEEG was valuable for patients who had new-onset events after the first evaluation and patients who were suspected as non-epilepsy, but had lasting paroxysmal events after the first evaluation. In patients diagnosed with pharmacoresistant focal epilepsy it might be worthwhile repeating a VEEG, although no patients proceeded to surgical operation. Funding: None