Diagnostic yield of sequential routine EEG and extended outpatient video-EEG monitoring

Pradeep N. Modur, Barbara Rigdon

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: To investigate the diagnostic yield of outpatient video-EEG monitoring (OVEM) in patients with suspected but unconfirmed epilepsy. Methods: OVEM data, comprised of 20-min video-EEG (REEG) followed by 4 h of video-EEG monitoring (EXM), from 179 consecutive patients were retrospectively analyzed. Three diagnostic categories were defined: localization-related epilepsy (LRE), generalized epilepsy (GE), and nonepileptic seizures (NES). Outcome measures were: frequency of events; diagnostic yield of entire OVEM; relative yields of REEG alone and EXM after nondiagnostic REEG; EXM diagnostic rate (yield of EXM after nondiagnostic REEG/yield of entire OVEM). Results: Habitual events occurred in 14 (8%) and 25 (15%) patients during REEG and EXM, respectively. Overall, OVEM was diagnostic in 90/179 patients (50%): LRE 21%; GE 15%; NES 15%. REEG alone was diagnostic in 49/179 patients (27%): LRE 7%; GE 13%; NES 7%. After nondiagnostic REEG, the subsequent EXM was diagnostic in 41/130 patients (32%): LRE (n = 24); GE (n = 2); NES (n = 15). The EXM diagnostic rate (95% confidence interval) was 0.65 (0.47-0.80) for LRE, 0.08 (0.01-0.25) for GE, and 0.56 (0.35-0.75) for NES. Conclusions: OVEM is useful in establishing and classifying epilepsy. Compared to REEG, EXM is relatively more beneficial in the diagnosis of LRE and NES rather than GE. Significance: This study outlines the benefits of extended outpatient video-EEG monitoring after nondiagnostic routine EEG.

Original languageEnglish (US)
Pages (from-to)190-196
Number of pages7
JournalClinical Neurophysiology
Volume119
Issue number1
DOIs
StatePublished - Jan 2008

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Electroencephalography
Outpatients
Generalized Epilepsy
Partial Epilepsy
Seizures
Epilepsy
Physiologic Monitoring
Outcome Assessment (Health Care)
Confidence Intervals

Keywords

  • EEG
  • Epilepsy
  • Outpatient
  • Seizure
  • Video-EEG monitoring

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems
  • Physiology (medical)

Cite this

Diagnostic yield of sequential routine EEG and extended outpatient video-EEG monitoring. / Modur, Pradeep N.; Rigdon, Barbara.

In: Clinical Neurophysiology, Vol. 119, No. 1, 01.2008, p. 190-196.

Research output: Contribution to journalArticle

Modur, Pradeep N. ; Rigdon, Barbara. / Diagnostic yield of sequential routine EEG and extended outpatient video-EEG monitoring. In: Clinical Neurophysiology. 2008 ; Vol. 119, No. 1. pp. 190-196.
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abstract = "Objective: To investigate the diagnostic yield of outpatient video-EEG monitoring (OVEM) in patients with suspected but unconfirmed epilepsy. Methods: OVEM data, comprised of 20-min video-EEG (REEG) followed by 4 h of video-EEG monitoring (EXM), from 179 consecutive patients were retrospectively analyzed. Three diagnostic categories were defined: localization-related epilepsy (LRE), generalized epilepsy (GE), and nonepileptic seizures (NES). Outcome measures were: frequency of events; diagnostic yield of entire OVEM; relative yields of REEG alone and EXM after nondiagnostic REEG; EXM diagnostic rate (yield of EXM after nondiagnostic REEG/yield of entire OVEM). Results: Habitual events occurred in 14 (8{\%}) and 25 (15{\%}) patients during REEG and EXM, respectively. Overall, OVEM was diagnostic in 90/179 patients (50{\%}): LRE 21{\%}; GE 15{\%}; NES 15{\%}. REEG alone was diagnostic in 49/179 patients (27{\%}): LRE 7{\%}; GE 13{\%}; NES 7{\%}. After nondiagnostic REEG, the subsequent EXM was diagnostic in 41/130 patients (32{\%}): LRE (n = 24); GE (n = 2); NES (n = 15). The EXM diagnostic rate (95{\%} confidence interval) was 0.65 (0.47-0.80) for LRE, 0.08 (0.01-0.25) for GE, and 0.56 (0.35-0.75) for NES. Conclusions: OVEM is useful in establishing and classifying epilepsy. Compared to REEG, EXM is relatively more beneficial in the diagnosis of LRE and NES rather than GE. Significance: This study outlines the benefits of extended outpatient video-EEG monitoring after nondiagnostic routine EEG.",
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