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Seizure. 2019 Mar;66:104-111. doi: 10.1016/j.seizure.2019.01.018.

Outcome of ambulatory video-EEG monitoring in a ˜10,000 patient nationwide cohort.

Author information

1
Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States. Electronic address: Tanvir.Syed@uhhospitals.org.
2
Department of Neurology and Comprehensive Epilepsy Program, Rhode Island Hospital, Brown Medical School, Providence, RI, United States; Department of Psychiatry and Human Behavior, Rhode Island Hospital, Brown Medical School, Providence, RI, United States.
3
Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.
4
Comprehensive Epilepsy Program, Department of Neurology, University of South Florida and Tampa General Hospital, Tampa, FL, United States.
5
University of Texas, McGovern Medical School, Department of Neurology, Houston, TX, United States; The Alliance Family of Companies, Irving, TX, United States.
6
Alfaisal University, College of Medicine, Riyadh, Saudi Arabia.
7
Charleston Area Medical Center, Charleston, WV, United States; Department of Neurology, West Virginia University, Morgantown, WV, United States.
8
Charleston Area Medical Center, Charleston, WV, United States.
9
St. Vincent Charity Medical Center, Cleveland, OH, United States.
10
Ross University School of Medicine, Portsmouth, Dominica.
11
Midwestern University, Chicago, IL, United States.
12
Case Western Reserve University, Cleveland, OH, United States.
13
Cleveland State University, Cleveland, OH, United States.
14
Epilepsy Center, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States.

Abstract

PURPOSE:

We evaluate outcome of in-home diagnostic ambulatory video-EEG monitoring (AVEM) performed on a nationwide cohort of patients over one calendar year, and we compare our findings with outcomes of inpatient adult and pediatric VEM performed during the same year at two academic epilepsy centers.

METHODS:

This is a retrospective cohort study. We obtained AVEM outcome data from an independent ambulatory-EEG testing facility. Inpatient VEM data from a 4-bed adult epilepsy center and an 8-bed pediatric epilepsy center were also included. Primary outcome measure was composite percentage of VEM records with epileptiform activity on EEG tracings or at least one video-recorded pushbutton event. We assessed patient-reported symptoms documented in AVEM event diaries.

RESULTS:

Of 9221 AVEM recordings performed across 28 states, 62.5% attained primary outcome. At least one patient-activated pushbutton event was captured on video in 54% of AVEM recordings (53.6% in adults, 56.1% in children). Epileptiform activity was reported in 1657 (18.0%) AVEM recordings (1473 [88.9%] only interictal, 9 [0.5%] only ictal, 175 [10.6%] both interictal and ictal). Most common patient-reported symptomatology during AVEM pushbutton events was behavioral/autonomic/emotional in adults and children. Compared to AVEM, inpatient VEM captured more confirmed representative events in adult and pediatric samples.

CONCLUSIONS:

AVEM is useful for non-urgent diagnostic evaluation of events.

KEYWORDS:

Ambulatory EEG; EEG; Epilepsy monitoring; Video/EEG use in epilepsy

PMID:
30910235
DOI:
10.1016/j.seizure.2019.01.018
[Indexed for MEDLINE]

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