Long-term EEG-video-audio monitoring: Detection of partial epileptic seizures and psychogenic episodes by 24-hour EEG record view

F. Pierelli, G. E. Chatrian, W. W. Erdly, P. D. Swanson

Research output: Contribution to journalArticlepeer-review

Abstract

Twenty-seven patients with medically refractory paroxysmal disorders underwent EEG-video-audio (EVA) monitoring in an inpatient neurology-neurosurgery unit over 1-15 (mean 8.9) days. Fast visual review of all EEG records (5,784 h) and subsequent analysis of synchronized EVA patterns demonstrated a total of 208 partial epileptic seizures (ES) in 12 individuals and 87 psychogenic episodes (PE) in 15 subjects. Clinical ES lasted 83.3 s on the average and were most frequent from day 7 to 9 of monitoring (42.3%) and during sleep (56.4%). PE were longer in duration (mean 724.5 s), most numerous during the first 2 days of monitoring (41.4%), and occurred exclusively during wakefulness. Subjects with PE signaled (by pressing on a push button) more events (35.6%) than did the individuals with ES (27.9%). Multiple observers raised the proportion of alarm to 69.0% of PE compared to 39.9% of ES. Following the alarm, nurses reached the patients' bedside within a brief time (mean 22.2 s). To differentiate partial ES from PE or to establish the association of these disorders, EVA monitoring is best performed around the clock over a period of 1-2 weeks. The limited number of paroxysmal events, especially ES, signaled by the patients should be considered when designing studies of the effectiveness of pharmacologic, surgical, and other treatments.

Original languageEnglish
Pages (from-to)513-523
Number of pages11
JournalEpilepsia
Volume30
Issue number5
Publication statusPublished - 1989

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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