Retrospective Analysis of Patients Undergoing Video-EEG Monitoring

Objective: Video-electroencephalography (EEG) monitoring (VEM) is an essential tool in diagnosing and treating epilepsy as it enables real-time monitoring and recording of electrical activity in the brain. We investigated the role of VEM in the diagnosis and treatment of epilepsy and recurrent paroxysmal events.Methods: We retrospectively examined patients monitored in our VEM unit between 2008-2016. We registered demographic and clinical information from the patients' files. The VEM was performed until at least three typical seizures were recorded or the predetermined recording period ended. An experienced neurologist reviewed and interpreted all video-EEG recordings and compared them to the initial diagnoses. Any changes in the diagnoses and treatment plans were recorded.Results: A total of 252 patients were included in this study. VEM was performed for pre-surgical planning or vagal nerve stimulation in 170 (67.46%), diagnosis/differantial diagnosis in 54 (21.42%), seizure classification in 18 (7.14%), and treatment follow-up in 10 patients (3.96%). A total of 187 patients (74.2%) had seizures [11 of whom had both epileptic seizures and psychogenic non-epileptic seizures (PNES)], 14 (5.55%) had only PNES, and one (0.39%) had a sleep attack due to idiopathic hypersomnia. VEM provided an additional contribution in diagnosis in 197 patients (78.17%). Diagnosis and management were changed in 26 (10.31%) and 175 patients (69.16%), respectively, following VEM.Conclusion: VEM plays a crucial role in the diagnosis and management of epilepsy, particularly when used in presurgical planning. In additionally, VEM, the gold standard in diagnosing PNES, may change the diagnosis, especially in patients with PNES or PNES plus epilepsy.