Abstracts

Video-EEG monitoring is a useful diagnostic tool for characterization of clinical events, as though the utility of re-monitoring once an initial diagnosis has been made is unclear. The aim of this study was to review patients who underwent two or more admissions for characterization of clinical events with video-EEG monitoring to determine whether the underlying diagnosis was altered by repeat admissions., We retrospectively identified adult patients (over 16 years of age) who underwent repeat admission for video-EEG monitoring between 1990 and 2006. Admissions for ictal SPECT and for intracranial monitoring as part of a pre-surgical evaluation were excluded. One hundred eighty patients were identified. Sixty-eight were male and 112 were female with an initial average age at monitoring of 31 years. Forty-seven (41.9%) patients were previously diagnosed with partial seizures, 30 (26.7%) with generalized onset seizures, 12 (10.0%) with psychogenic, non-epileptic attacks (PNEA), and 23 (20.0%) with both epileptic seizures and PNEA. Two reasons for repeat monitoring were identified: changing clinical description of events and increasing event frequency., Of 56 patients with partial seizures, monitoring diagnosed new PNEA in 19 (33.9%). Ten of these 19 were after epilepsy surgery. Twenty-one patients underwent a repeat pre-surgical evaluation. Eleven of those 21 patients were identified as surgical candidates with an average time between monitoring of 52.7 months (18 to 105 months). The site of proposed surgery did not change in 8 (66.6%) patients of that group. Of 35 patients with generalized onset seizures, monitoring diagnosed partial seizures in 2 (5.7%). Of 12 patients with PNEA, remonitoring diagnosed previously unrecognized epilepsy in four (33.3%)., Repeat admission for video-EEG monitoring may be a useful diagnostic tool and clarify new events particularly in patients with a prior history of partial seizures or PNEA reporting a new event type.,