Abstract
Although the epilepsy and neurology communities have position papers on a number of topics pertaining to epilepsy diagnosis and management, no current paper exists for the rationale and appropriate indications for epilepsy monitoring unit (EMU) evaluation. General neurologists, hospital administrators, and insurers also have yet to fully understand the role this type of testing has in the diagnosis and management of individuals with paroxysmal neurologic symptoms. This review outlines the indications for long-term video-electroencephalography (VEEG) for typical elective admissions to a specialized inpatient setting. The common techniques used in EMUs to obtain diagnostic information are reviewed. The added benefit of safety measures and clinical testing above that available for routine or long-term ambulatory electroencephalography is also discussed. The indications for admission to the EMU include differential diagnosis of paroxysmal spells, characterization of seizure types, presurgical epilepsy evaluations, seizure quantification, monitoring medication adjustment in a safe setting, and differentiation between seizures and side effects. We conclude that the appropriate use of this specialized testing can lead to an early and correct diagnosis in a variety of clinical circumstances. The EMU evaluation is considered the gold standard test for the definitive diagnosis of epilepsy and seizure-like spells.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 27-36 |
| Number of pages | 10 |
| Journal | Epilepsia |
| Volume | 59 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2018 |
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Keywords
- epilepsy monitoring
- epilepsy surgery
- inpatient specialized testing
- nonepileptic events
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
Cite this
Indications and methodology for video-electroencephalographic studies in the epilepsy monitoring unit. / Shih, Jerry J.; Fountain, Nathan B.; Herman, Susan T.; Bagic, Anto; Lado, Fred; Arnold, Susan; Zupanc, Mary L.; Riker, Ellen; Labiner, David M.
In: Epilepsia, Vol. 59, No. 1, 01.01.2018, p. 27-36.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Indications and methodology for video-electroencephalographic studies in the epilepsy monitoring unit
AU - Shih, Jerry J.
AU - Fountain, Nathan B.
AU - Herman, Susan T.
AU - Bagic, Anto
AU - Lado, Fred
AU - Arnold, Susan
AU - Zupanc, Mary L.
AU - Riker, Ellen
AU - Labiner, David M.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Although the epilepsy and neurology communities have position papers on a number of topics pertaining to epilepsy diagnosis and management, no current paper exists for the rationale and appropriate indications for epilepsy monitoring unit (EMU) evaluation. General neurologists, hospital administrators, and insurers also have yet to fully understand the role this type of testing has in the diagnosis and management of individuals with paroxysmal neurologic symptoms. This review outlines the indications for long-term video-electroencephalography (VEEG) for typical elective admissions to a specialized inpatient setting. The common techniques used in EMUs to obtain diagnostic information are reviewed. The added benefit of safety measures and clinical testing above that available for routine or long-term ambulatory electroencephalography is also discussed. The indications for admission to the EMU include differential diagnosis of paroxysmal spells, characterization of seizure types, presurgical epilepsy evaluations, seizure quantification, monitoring medication adjustment in a safe setting, and differentiation between seizures and side effects. We conclude that the appropriate use of this specialized testing can lead to an early and correct diagnosis in a variety of clinical circumstances. The EMU evaluation is considered the gold standard test for the definitive diagnosis of epilepsy and seizure-like spells.
AB - Although the epilepsy and neurology communities have position papers on a number of topics pertaining to epilepsy diagnosis and management, no current paper exists for the rationale and appropriate indications for epilepsy monitoring unit (EMU) evaluation. General neurologists, hospital administrators, and insurers also have yet to fully understand the role this type of testing has in the diagnosis and management of individuals with paroxysmal neurologic symptoms. This review outlines the indications for long-term video-electroencephalography (VEEG) for typical elective admissions to a specialized inpatient setting. The common techniques used in EMUs to obtain diagnostic information are reviewed. The added benefit of safety measures and clinical testing above that available for routine or long-term ambulatory electroencephalography is also discussed. The indications for admission to the EMU include differential diagnosis of paroxysmal spells, characterization of seizure types, presurgical epilepsy evaluations, seizure quantification, monitoring medication adjustment in a safe setting, and differentiation between seizures and side effects. We conclude that the appropriate use of this specialized testing can lead to an early and correct diagnosis in a variety of clinical circumstances. The EMU evaluation is considered the gold standard test for the definitive diagnosis of epilepsy and seizure-like spells.
KW - epilepsy monitoring
KW - epilepsy surgery
KW - inpatient specialized testing
KW - nonepileptic events
UR - http://www.scopus.com/inward/record.url?scp=85041800912&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041800912&partnerID=8YFLogxK
U2 - 10.1111/epi.13938
DO - 10.1111/epi.13938
M3 - Review article
C2 - 29124760
AN - SCOPUS:85041800912
VL - 59
SP - 27
EP - 36
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - 1
ER -