Abstract
Differential diagnosis in epilepsy is sometimes challenging. Video-electroencephalography (V-EEG) is an essential tool in the diagnosis and management of epilepsy. The prolonged duration of V-EEG recording increases the diagnostic yield of a conventional V-EEG. The right length of monitoring for different indications is still to be established. We present a retrospective descriptive study with a sample of 50 patients with long-term V-EEG monitoring, with a mean age of 36.1 years, monitored from 2013 to 2019 at the Burgos University Hospital. The mean monitoring time was 3.6 days. Events were obtained in 76% of the patients, corresponding to epileptic seizures (ES) in 57.9% of them, with psychogenic non-epileptic seizures (PNES) in 39.5%, and with episodes of both pathologies in 2.6% of the patients. We found that the first event was highly representative, and it correlated with the rest of the events that would be recorded. Moreover, 92% of the first PNES had been captured at the end of the second day, and 89% of the first ES by the end of the third day. V-EEG for differential diagnosis between ES and PNES can be performed in hospitals without specialized epilepsy surgery units. For this indication, the duration of long-term V-EEG can be adjusted individually depending on the nature of the first event.
Highlights
The correct diagnosis of epilepsy has essential implications for the patient’s health, occupation, and social interactions
This study presents a cohort of patients who underwent long-term V-EEG with different indications at the Burgos University Hospital (HUBU)
It is a third-level hospital that cares for patients with epilepsy, where there is the possibility of carrying out long-term V-EEG monitoring, mainly for differential diagnosis and improvement of the management of antiepileptic drug (AED) in pharmacoresistant epilepsy
Summary
The correct diagnosis of epilepsy has essential implications for the patient’s health, occupation, and social interactions. Given the wide variety of events that resemble an epileptic seizure (ES), establishing a correct diagnosis is sometimes challenging [1]. Different studies show a general rate of misdiagnosis between 20% and 40%, which entails a series of negative psychological and socioeconomic repercussions for the patient and different economic implications for the health services [2,3,4]. Epilepsy and other paroxysmal events are diagnosed through both clinical presentation and V-EEG recordings. V-EEG is the recording of the bioelectrical brain activity coupled to a simultaneous video recording that can be thoroughly analyzed [5,6,7]. Its usefulness is not debated regarding any of its possible indications (diagnosis of epilepsy, differential diagnosis, presurgical workup, and treatment decisions) and modalities
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