Yield of Interictal Epileptiform Activity in Ambulatory EEG versus Epilepsy Monitoring Unit: A Matched Comparison
Abstract number :
3.144
Submission category :
3. Neurophysiology / 3C. Other Clinical EEG
Year :
2021
Submission ID :
1826306
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Yara Mikhaeil-Demo, MD - Northwestern University Feinberg School of Medicine; Elizabeth Bachman, MPH - Department of Neurology - Northwestern University Feinberg School of Medicine; Karina Gonzalez Otarula, MD - University of Iowa; Anne Berg, PhD - Lurie Children’s Hospital; Stephan Schuele, MD - Northwestern University Feinberg School of Medicine
Rationale: There is ongoing debate if the yield of capturing interictal epileptiform activity (IEA) is different in patients who undergo ambulatory EEG (AEEG) vs. inpatient EEG monitoring (EMU). We directly compare the yield of IEA in patients evaluated for seizures who underwent AEEG and EMU and if that difference is influenced by the duration of recording, the peri-ictal state, antiseizure medication withdrawal or placement of additional electrodes.
Methods: This is a single center retrospective chart review study of patients who had both AEEG evaluation and EMU admission between 2013 and 2020.
Results: 343 adult patients with a history of suspected seizures (N=215, 63% women) evaluated with both AEEG and in the EMU on separate occasions. The EMU was the first of the two EEGs for 148 (43%). The average age of epilepsy onset was 27.1y (SD=17.5) and the average age at the first of the two EEG evaluations was 39.5y (SD=15.1). During the preceding clinical visit, 175 (51%) were suspected to have focal epilepsy, 51 (15%) generalized or multifocal epilepsy and the remaining 117 (34%) had single or acute symptomatic seizure or unclear events. EMU studies were longer than AEEG (median 4d (IQR 4 – 5d) vs 2d (IQR 1 – 2d), p< 0.0001). Medications were reduced or stopped for 280 (82%) of EMU; additional electrodes were also placed for 174 (51%) of EMU.
Neurophysiology