Eficacia de la monitorización videoelectroencefalográfica prolongada con protocolo específico de activación cerebral en el diagnóstico diferencial de la epilepsia

Abstract

ObjectiveTo analyze the usefulness of a specific EEG activation protocol during video-EEG (VEEG) monitoring in the differential diagnosis of epilepsy. MethodSince January 2009, 181 patients underwent two different EEG activation protocols during VEEG monitoring in the Epilepsy Unit of Hospital Ruber International. One protocol (the “standard protocol”) included hyperventilation and intermittent photo-stimulation while the other (“specific protocol”) consisted of potentially provocative cognitive tasks (reading, writing, calculation and spatial construction). Both protocols where supervised by specialized epilepsy nurses, who assessed the correct performance of these activation tasks. ResultsAfter applying the two protocols during VEEG monitoring a diagnosis of focal epilepsy (FE) was achieved in 144 out of 181 patients and idiopathic generalized epilepsy (IGE) in 37 out of 181. The specific activation protocol induced epileptiform activity (EA) or seizures in 34 out of 37 patients in the IGE group and in none in the FE group. Fifteen of our IGE patients had a wrong diagnosis of FE before being evaluated with VEEG using the specific protocol, and the wrong diagnoses could be corrected after the study. In three patients of the IGE group the VEEG was normal. ConclusionsOur results suggest that the application of these specific activation techniques that included cognitive tasks is a simple and useful tool in the diagnosis of epilepsy.