Minimum standards for inpatient long-term video-EEG monitoring: A clinical practice guideline of the international league against epilepsy and international federation of clinical neurophysiology

Tatum, William O.; Mani, Jayanti; Jin, Kazutaka; Halford, Jonathan J.; Gloss, David; Fahoum, Firas; Maillard, Louis; Mothersill, Ian; Beniczky, Sándor

doi:10.1016/j.clinph.2021.07.016

Cited by 32 publications

(37 citation statements)

References 278 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the overall quality of evidence for recording standards of routine and sleep EEG is low, which is an important limitation. This article is the second joint IFCN‐ILAE EEG guideline in addition to recently published “Minimum standards for inpatient long‐term video‐electroencephalographic monitoring: A clinical practice guideline of the International League Against Epilepsy and International Federation of Clinical Neurophysiology 104 . The minimum standards summarize the available evidence based on systematic review and provides the first expert consensus‐based global standards to record EEG (Table 6).…”

Section: Resultsmentioning

confidence: 99%

“…This article is the second joint IFCN-ILAE EEG guideline in addition to recently published "Minimum standards for inpatient long-term videoelectroencephalographic monitoring: A clinical practice guideline of the International League Against Epilepsy and International Federation of Clinical Neurophysiology. 104 The minimum standards summarize the available evidence based on systematic review and provides the first expert consensus-based global standards to record EEG (Table 6). Although the recommendations are conditional, they provide feasible international standards for new EEG laboratories and challenge established EEG laboratories to evaluate their protocols and to tailor implementation strategies of recommendations to the local context.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Routine and sleep EEG: Minimum recording standards of the International Federation of Clinical Neurophysiology and the International League Against Epilepsy

et al. 2023

Self Cite

View full text Add to dashboard Cite

This article provides recommendations on the minimum standards for recording routine (“standard”) and sleep electroencephalography (EEG). The joint working group of the International Federation of Clinical Neurophysiology (IFCN) and the International League Against Epilepsy (ILAE) developed the standards according to the methodology suggested for epilepsy‐related clinical practice guidelines by the Epilepsy Guidelines Working Group. We reviewed the published evidence using the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) statement. The quality of evidence for sleep induction methods was assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method. A tool for Quality Assessment of Diagnostic Studies (QUADAS‐2) was used to assess the risk of bias in technical and methodological studies. Where high‐quality published evidence was lacking, we used modified Delphi technique to reach expert consensus. The GRADE system was used to formulate the recommendations. The quality of evidence was low or moderate. We formulated 16 consensus‐based recommendations for minimum standards for recording routine and sleep EEG. The recommendations comprise the following aspects: indications, technical standards, recording duration, sleep induction, and provocative methods.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Routine and sleep EEG: Minimum recording standards of the International Federation of Clinical Neurophysiology and the International League Against Epilepsy

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…For epileptologists, an EEG-video recording is similar to a “seizure biopsy.” It is to the epileptologist what the skin biopsy is to the dermatologist. By recording the episode in question, it achieves the following: 1-3 1. Confirms the diagnosis of epileptic seizures vs other episodes that can mimic seizures;2.…”

Section: Eeg-video Monitoring Is the Gold-standard For The Evaluation...mentioning

confidence: 99%

“…In most situations, both components (EEG and video) are important, including interpreting each one in the context of each other. 1-5…”

Section: Eeg-video Monitoring Is the Gold-standard For The Evaluation...mentioning

confidence: 99%

The Best Seizure Diagnostic Tool Is Not a Medical Device

Benbadis

2023

Neur Clin Pract

View full text Add to dashboard Cite

The diagnosis of seizures and epilepsy is primarily based on the history, but history-taking is fraught with difficulties and has serious limitations, which is one reason for the common misdiagnosis of seizures. EEG is a very useful tool, but routine EEG has poor sensitivity, and prolonged EEG-video monitoring, the gold-standard for diagnosis, is only useful for patients with frequent events. Smartphones are ubiquitous, and their videos are increasingly used as an extension of the history and a diagnostic tool. Stand-alone videos should be considered a diagnostic tool and treated as such, including with a Current Procedural Terminology (CPT) code, the American uniform nomenclature for medical procedures, which is used for billing and reimbursement.

show abstract

“…The current study aimed to evaluate how much time is needed to record epileptic seizures by HVEM. We posed goals of capturing one, three, or five seizures on different days, corresponding to different clinical needs of video-EEG varying from just discrimination of epileptic/non-epileptic events to recording a variety of non-clustered seizures required for reasonable exclusion of multiple epileptic foci (9,10). We based our evaluation on natural seizure frequencies reported in a large cohort of more than a million seizures logged by 10,186 adult and pediatric patients in a large electronic seizure diary (11).…”

Section: Copyright Introductionmentioning

confidence: 99%

What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study

et al. 2022

View full text Add to dashboard Cite

Ambulatory “at home” video-EEG monitoring (HVEM) may offer a more cost-effective and accessible option as compared to traditional inpatient admissions to epilepsy monitoring units. However, home monitoring may not allow for safe tapering of anti-seizure medications (ASM). As a result, longer periods of monitoring may be necessary to capture a sufficient number of the patients' stereotypic seizures. We aimed to quantitatively estimate the necessary length of HVEM corresponding to various diagnostic scenarios in clinical practice. Using available seizure frequency statistics, we estimated the HVEM duration required to capture one, three, or five seizures on different days, by simulating 100,000 annual time-courses of seizure occurrence in adults and children with more than one and <30 seizures per month (89% of adults and 85% of children). We found that the durations of HVEM needed to record 1, 3, or 5 seizures in 80% of children were 2, 5, and 8 weeks (median 2, 12, and 21 days), respectively, and significantly longer in adults −2, 6, and 10 weeks (median 3, 14, and 26 days; p < 10−10 for all comparisons). Thus, longer HVEM than currently used is needed for expanding its clinical value from diagnosis of nonepileptic or very frequent epileptic events to a presurgical tool for patients with drug-resistant epilepsy. Technical developments and further studies are warranted.

show abstract

Minimum standards for inpatient long-term video-EEG monitoring: A clinical practice guideline of the international league against epilepsy and international federation of clinical neurophysiology

Cited by 32 publications

References 278 publications

Routine and sleep EEG: Minimum recording standards of the International Federation of Clinical Neurophysiology and the International League Against Epilepsy

Routine and sleep EEG: Minimum recording standards of the International Federation of Clinical Neurophysiology and the International League Against Epilepsy

The Best Seizure Diagnostic Tool Is Not a Medical Device

What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study

Contact Info

Product

Resources

About