Video-EEG monitoring: Safety and adverse events in 507 consecutive patients

Dobesberger, Judith; Walser, Gerald; Unterberger, Iris; Seppi, Klaus; Kuchukhidze, Giorgi; Larch, Julia; Bauer, Gerhard; Bodner, Thomas; Falkenstetter, Tina; Ortler, Martin; Luef, Gerhard; Trinka, Eugen

doi:10.1111/j.1528-1167.2010.02782.x

Cited by 90 publications

(128 citation statements)

References 18 publications

(34 reference statements)

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“…Importantly, tapering or withdrawal of AEDs has been believed to be potentially dangerous, as it carries a 3% risk of status epilepticus or cluster seizures [4,13,21,22]. Therefore, most epilepsy centers gradually taper or partially discontinue AEDs [10,19].…”

Section: Discussionmentioning

confidence: 99%

“…Video-EEG (VEEG) monitoring is recommended as the gold standard for diagnosis of epilepsy, classification of seizures/epilepsy, and pre-surgical evaluation [1][2][3][4][5][6][7]. The optimal duration of VEEG monitoring has not been determined but it was found to be between 3 to 6 days in most reported studies to capture more than one seizure [1,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

Dhuha

Konno

Yokota

et al. 2017

E&S

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Purpose:The pur pose of this study was to deter mine the optimal dur ation of long-term video-EEG monitoring (VEEG) in patients with epilepsy. The response time of medical staff to seizures was also evaluated from the viewpoint of safety of the monitoring. Methods: We estimated the optimal duration of VEEG from the seizure onset pattern. We retrospectively investigated all VEEG sessions performed in our department during the period between June 2005 and July 2016. Sessions with no seizures and with only non-epileptic seizures were excluded. Using 91 sessions from 69 patients, information on the onset time and response time of medical staff to seizures was collected. Results: The median duration from the start of VEEG to the first seizure was 2 days. Seventy-seven percent of first seizures occurred within 3 days of VEEG. The median duration from the first seizure to the third seizure was 2 days. Eighty percent of third seizures occurred within 3 days of the first seizure. There was no significant diurnal distribution of seizure occurrence. Medical staff did not respond to 20% of generalized seizures and 69% of focal seizures. The overlooking of generalized seizures occurred mainly during the hours of 1-2 pm and 8-9 pm but there was no significant diurnal pattern in overlooking generalized and focal seizures.Conclusion：Based on these findings, we suggest that VEEG can be terminated when no seizure occurs within 4 days after onset. In our VEEG protocol, in which all antiepileptic drugs were discontinued before the start of a session, there was no diurnal pattern of seizure occurrence. This is the first study investigating the diurnal pattern of overlooking seizures by medical staff during VEEG. Since there was no diurnal pattern to the overlooking, medical staff should pay equal, 24-hour attention to patients on VEEG.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

Dhuha

Konno

Yokota

et al. 2017

E&S

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“…Zaključci koji se mogu dovesti posle dugotrajnog video-EEG monitoringa zavise od interiktalnog EEG zapisa, kao i video i elektrografskog zapisa paroksizmalnih događaja. U našoj seriji, kao i sa iskustvima drugih centara, fokalna epilepsija je najčešći uzrok, a neepileptični događaji beleže se u oko 10 do 30% slučajeva (115,116). Vrlo slično kao i u ovoj studiji, tokom video-EEG monitoringa na Klinici za neurologiju u Innsbrucku, oko 20% bolesnika nije imalo napade, ali je imalo interiktalni EEG nalaz koji je odgovarao epilepsiji (115).…”

Section: Sindromska Klasifikacija Bolesnika Posle Dugotrajnog Video-eunclassified

“…U našoj seriji, kao i sa iskustvima drugih centara, fokalna epilepsija je najčešći uzrok, a neepileptični događaji beleže se u oko 10 do 30% slučajeva (115,116). Vrlo slično kao i u ovoj studiji, tokom video-EEG monitoringa na Klinici za neurologiju u Innsbrucku, oko 20% bolesnika nije imalo napade, ali je imalo interiktalni EEG nalaz koji je odgovarao epilepsiji (115). Razloge za ovakav scenario treba tražiti u vremenskom ograničenju dugotrajnog video-EEG monitoringa (medijana 4 dana u našoj studiji i 5 dana u insbruškoj seriji), ali i nekonzistentnosti koja se dobija suočavanjem podataka o frekvenciji napada iz anamneze i frekvencije koja se dobija tokom ove procedure (117).…”

Section: Sindromska Klasifikacija Bolesnika Posle Dugotrajnog Video-eunclassified

“…U ovoj studiji medijana ukupnih napada je pet što je nešto više u odnosu na slične studije koje su istraživale različite aspekte dugotrajnog video-EEG monitoringa (2 -4 napada) (117,115). Mogući razlog za ovakvu diskrepancu leži u načinu ukidanja antiepileptičnih lekova u Jedinici za dugotrajni video-EEG monitoring na Klinici za neurologiju.…”

Section: Učestalost I Tip Epileptičnih Napada I Njihova Dužinaunclassified

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Correlation of the patterns of behavior in focal epileptic seizures and localization of the epileptic lesions

Ristić¹

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Assessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures

et al. 2020

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IMPORTANCE Misdiagnosis of epilepsy is common. Video electroencephalogram provides a definitive diagnosis but is impractical for many patients referred for evaluation of epilepsy.OBJECTIVE To evaluate the accuracy of outpatient smartphone videos in epilepsy. DESIGN, SETTING, AND PARTICIPANTSThis prospective, masked, diagnostic accuracy study (the OSmartViE study) took place between August 31, 2015, and August 31, 2018, at 8 academic epilepsy centers in the United States and included a convenience sample of 44 nonconsecutive outpatients who volunteered a smartphone video during evaluation and subsequently underwent video electroencephalogram monitoring. Three epileptologists uploaded videos for physicians from the 8 epilepsy centers to review. MAIN OUTCOMES AND MEASURES Measures of performance (accuracy, sensitivity, specificity, positive predictive value, and negative predictive value) for smartphone video-based diagnosis by experts and trainees (the index test) were compared with those for history and physical examination and video electroencephalogram monitoring (the reference standard). RESULTS Forty-four eligible epilepsy clinic outpatients (31 women [70.5%]; mean [range] age, 45.1 [20-82] years) submitted smartphone videos (530 total physician reviews). Final video electroencephalogram diagnoses included 11 epileptic seizures, 30 psychogenic nonepileptic attacks, and 3 physiologic nonepileptic events. Expert interpretation of a smartphone video was accurate in predicting a video electroencephalogram monitoring diagnosis of epileptic seizures 89.1% (95% CI, 84.2%-92.9%) of the time, with a specificity of 93.3% (95% CI, 88.3%-96.6%). Resident responses were less accurate for all metrics involving epileptic seizures and psychogenic nonepileptic attacks, despite greater confidence. Motor signs during events increased accuracy. One-fourth of the smartphone videos were correctly diagnosed by 100% of the reviewing physicians, composed solely of psychogenic attacks. When histories and physical examination results were combined with smartphone videos, correct diagnoses rose from 78.6% to 95.2%. The odds of receiving a correct diagnosis were 5.45 times greater using smartphone video alongside patient history and physical examination results than with history and physical examination alone (95% CI, 1.01-54.3; P = .02). CONCLUSIONS AND RELEVANCEOutpatient smartphone video review by experts has predictive and additive value for diagnosing epileptic seizures. Smartphone videos may reliably aid psychogenic nonepileptic attacks diagnosis for some people.

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Video-EEG monitoring: Safety and adverse events in 507 consecutive patients

Cited by 90 publications

References 18 publications

Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

Timing of seizure occurrence and response of medical staff in video-EEG monitoring for drug-resistant epilepsy

Correlation of the patterns of behavior in focal epileptic seizures and localization of the epileptic lesions

Assessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures

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