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. 2023 Aug 7:8:164-168.
doi: 10.1016/j.cnp.2023.07.004. eCollection 2023.

Additional overnight video EEG for the diagnosis of epilepsy: Experiences from Western Kenya

Nshimiyimana Jules Fidele  1
Affiliations

Additional overnight video EEG for the diagnosis of epilepsy: Experiences from Western Kenya

Nshimiyimana Jules Fidele. Clin Neurophysiol Pract. .

Abstract

Objective: The prolonged video EEG monitoring is widely used for the diagnosis and management of epilepsy, especially during the presurgical evaluation. The routine practice in neurology is to order a prolonged recording like an overnight EEG when the initial routine EEG is normal or unrevealing. Only few studies have evaluated this sequential approach and we aimed in this study to evaluate the added diagnostic value of a relatively brief video EEG monitoring especially in developing nations where the history of seizure semiology may be harder to obtain, and the video EEG monitoring technology is scarce.

Methods: This study analyzed retrospectively 167 overnight video EEG records in one of the secondary healthcare facilities in Western Kenya between March 2018 and March 2021. The indications were mainly further diagnosis and seizure classification. All the patients had an unrevealing routine EEG and 162 of them were normal.

Results: Additional epileptiform discharges were recorded in 91 of those 162 with initial normal routine EEG. Further classification of seizure was achieved in 67 patients among 112 with initially unclassified seizure before the overnight recording. The improvement of 68% (97 out of 143 patients without a prior epilepsy diagnosis) for the diagnosis of epilepsy in those patients without initial final diagnosis is comparable to other similar studies but mostly with a longer duration of recording. The diagnosis was changed or at least improved in 142 (85%) patients out of the 167 patients who underwent the overnight video EEG. The treatment modification was immediately considered in 116 after the prolonged recording.

Conclusions: Adding an overnight video EEG to an unrevealing routine EEG can significantly increase the likelihood of detecting additional epileptiform discharges in patients with epilepsy, thereby improving diagnostic yield and aiding in treatment adjustment for all patients suspected of having epilepsy.

Significance: The sequential approach of adding a prolonged video EEG monitoring even as brief as an overnight video EEG to an unrevealing routine EEG has a very significant impact in further classification of seizure and diagnosis of epilepsy especially in a resource limited set up.

Keywords: Epilepsy; Epileptiform; Ictal recording; overnight video EEG.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Findings after the overnight video EEG according to the indication for recording.
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References

    1. Alving J., Beniczky S. Diagnostic usefulness and duration of the inpatient long-term video-EEG monitoring: Findings in patients extensively investigated before the monitoring. Seizure. 2009;18:470–473. doi: 10.1016/j.seizure.2009.04.005. - DOI - PubMed
    1. Baldin E., Hauser W.A., Buchhalter J.R., Hesdorffer D.C., Ottman R. Yield of epileptiform electroencephalogram abnormalities in incident unprovoked seizures: A population-based study. Epilepsia. 2014;55:1389–1398. doi: 10.1111/epi.12720. - DOI - PMC - PubMed
    1. Boon P., Michielsen G., Goossens L., Drieghe C., D’Have M. Interictal and ictal video-EEG monitoring. Acta Neurologica Belgica. 1999;99:247–255. - PubMed
    1. Fisch L., Lascano A.M., Vernaz Hegi N., Girardin F., Kapina V., Heydrich L., et al. Early specialized care after a first unprovoked epileptic seizure. Journal of Neurology. 2016;263:2386–2394. doi: 10.1007/s00415-016-8272-3. - DOI - PubMed
    1. Ghougassian D.F., D’Souza W., Cook M.J., O’Brien T.J. Evaluating the Utility of Inpatient Video-EEG Monitoring. Epilepsia. 2004;45:928–932. doi: 10.1111/j.0013-9580.2004.51003.x. - DOI - PubMed

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