[A video-EEG description of non-epileptic paroxysmal seizures]

Abstract

Introduction: Paroxystic disorders, especially of motor type, mean that sometimes interpretation and classification as epileptic or non-epileptic is difficult. In these cases a recording of the episodes synchronized with an EEG may help diagnosis.

Development: By means of digital EEG and video we have recorded various episodes similar to epileptic seizures, in which lack of correlation between the absence of paroxysms on the recording and the clinical anomalies is well seen, and therefore this investigation is more than justified. In some cases it has allowed medication to be stopped in patients who were being treated as though they were epileptics when in fact they were not. In others, such as a case of syncope with subsequent convulsions, we showed that on the EEG there was slowing followed by reduction in the amplitude representing cortical extinction, far from paroxystic hypersynchrony. Hypnagogic nocturnal episodes are differentiated from true myoclonic epilepsies. We have shown pseudo-seizures which were very similar to the automatisms of epileptic complex partial crises, without electrical changes apart from the extracerebral artefacts due to the patient's movements.

Conclusion: In every patient in whom there is reasonable doubt as to whether the motor disorders are of cerebral origin or not, a long duration synchronized video-EEG is essential, done both whilst awake and asleep.